Saturday, October 12, 2013

Electroconvulsive Therapy (ECT)


Electroconvulsive therapy (ECT) is more commonly known as electroshock therapy, and most commonly associated with its use in “treating” patients in mental hospitals. When properly performed, electric currents are passed through the brain to intentionally trigger a brief seizure. This seems to cause a change in brain chemistry that can quickly reverse symptoms of certain mental illnesses. This is most often used when other treatments are unsuccessful.

When people hear the words electroshock therapy, they picture an image similar to Jack Nicholson in “One Flew over the Cuckoo’s Nest” where he is forced on a gurney without anesthesia, with two electrodes connected to his temples, with him thrashing about having violent seizures. It was common in early mental hospitals to perform this therapy without anesthesia. They would detain the patient onto a gurney, place two electrodes on the temples, place a bite block in the mouth so they would not bite off their own tongue, then produce high doses of electricity causing violent seizures. These seizures were so violent it wasn’t uncommon for the patient to have memory loss, fractured bones, and other serious side effects.

Today electroconvulsive therapy is safer and only performed on people while they are under general anesthesia. ECT is used to treat severe depression, especially when accompanied by psychosis like a desire to commit suicide, severe mania that occurs as part of bipolar disorder, catatonia, and agitation and aggression in people with dementia. This therapy is a good treatment option when medications aren’t tolerated or other therapies haven’t worked. In certain cases, ECT is used during pregnancy when medications can’t be taken to avoid harming the fetus, elderly adults who can’t tolerate drug side effects, and when ECT has been successful in the past.

Risks and side effects of therapy may include confusion, memory loss, physical side effects, and medical complications. One type of memory loss associated with electroshock therapy is retrograde amnesia. Retrograde amnesia is having trouble remembering events that occurred before treatment began. Physical side effects include nausea, vomiting, headache, jaw pain, muscle ache and/or muscle spasms.

There are two types of electroconvulsive therapy today. Unilateral, where electrical currents focus on only one side of the brain, and bilateral, where both sides of the brain receive electrical currents. Generally in the United States, treatments are given two to three times weekly, for three to four weeks – for a total of six to 12 treatments.

Despite the bad reputation this specific therapy receives, with modern inventions and new regulations on the treatment, it can be a beneficial treatment for some of the most serious psychiatric health problems.