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Electroconvulsive therapy (ECT)

Explains what electroconvulsive therapy (ECT) is, when it might be used and what happens during the treatment.

What is electroconvulsive therapy (ECT)?

Electroconvulsive therapy, or ECT for short, is a treatment that involves sending an electric current through your brain, causing a brief surge of electrical activity within your brain (also known as a seizure). The aim of the treatment is to relieve the symptoms of some mental health problems.

ECT is given under a general anaesthetic, so you aren't awake during the treatment.

What problems can ECT treat?

The National Institute for Health and Care Excellence (NICE) recommends that ECT is only used to achieve quick, short-term improvements if you have:

  • severe or life-threatening depression and your life is at risk so you need urgent treatment
  • moderate to severe depression and other treatments such as medication and talking therapies haven't helped you
  • catatonia (staying frozen in one position, or making very repetitive or restless movements)
  • a severe or long-lasting episode of mania.

Repeated ECT is only recommended if you have previously responded well to it, or if all other options have been considered.

ECT is not recommended for ongoing management of schizophrenia, or as a routine treatment for mild to moderate depression.

You can read full guidelines on the NICE website for using ECT to treat catatonia, mania or schizophrenia, and as one of the treatments for moderate or severe depression.

Is ECT effective?

It’s very difficult to know how ECT works, or how effective it is. Many different theories have been suggested, but research hasn’t shown exactly what effects it has or how these might help with mental health problems.

Some people find ECT helpful while others don’t. If you are thinking about having ECT, it’s important that you are given full information about the treatment. See our page on deciding to have ECT for more information.

Supporting someone else

If you're worried about someone who may have ECT treatment, our pages on how to cope when supporting someone else and helping someone else seek help give suggestions on what you can do, and where you can go for support.

"It didn't work overnight but as my course of nine progressed I could feel the huge weight of black, black fog lift from my mind."

Why is ECT controversial?

The use of ECT can be controversial for several reasons:

  • It was used unethically in the past. ECT was used far more in the 1950s to 1970s than it is today, and it was used without anaesthetic and often without consent. This has sometimes been shown in films and TV shows, which may not reflect how ECT is carried out today.
  • It can sometimes cause memory loss. This is often short-term, but can be longer-lasting as well. See our page on the side effects of ECT for more information.
  • Some people are offered ECT without being offered other treatments they may prefer to try first, such as talking therapies for depression.
  • Professionals disagree about whether to use it. Some healthcare professionals see ECT as a helpful treatment, while others say it should not be used.

This information was published in July 2019. We will revise it in 2022.

References and bibliography available on request.

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