Electroconvulsive therapy (ECT)
Electroconvulsive therapy (ECT) is a treatment to help your brain regulate mood. It is used to treat major depression, bipolar affective disorder, schizophrenia, neuroleptic malignant syndrome and delirium.
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[LIGHT MUSIC] We recognize that many of you have not seen an electroconvulsive therapy treatment, the equipment, or our facilities. We put together a video to provide a visual of what a patient experiences on an ECT treatment day.
The majority of patients receive ECT as outpatients. On the day of treatment, patients check in at our surgery centers. Patients first arrive in our pre-op area, where we obtain vital signs and any needed lab work.
Next, nursing staff complete a health assessment and screen for side effects, including pain, nausea, or changes in cognition. We use formal screens, including the PHQ9, GAD7, and St. Louis University Mental Status Exam during the ECT series. These tools help track patient response and side effects to ECT.
ECT is conducted under general anesthesia. Nursing staff place IVs, which is used to deliver the anesthetic and muscle paralytic. The anesthesiologist also meets with the patient. ECT is conducted in a procedural suite, and team members include a psychiatrist, procedural nurse, anesthesiologist, and nurse anesthetist.
Before anesthesia, EEG electrodes are placed on the patient. These are painless adhesives. We use the EEG to monitor seizure duration and quality.
Next, the stimulus electrodes are placed on the patient's head. The adhesives deliver the electricity that creates the seizure. We enter the stimulus parameters, which are tailored to the patient's seizure threshold.
Two primary medications are used during the procedure. First, the anesthetic ensures patients are fully sedated and amnestic. Then we give a muscle paralytic such that motor movement is minimal during the seizure.
Anesthesia manages the patient's airway with mask ventilation. We use a foam bite block to protect the teeth and tongue because jaw muscles are activated by the stimulus.
The electrical stimulus generates a generalized seizure that typically lasts between 30 and 60 seconds. The seizure is monitored visually by looking at muscle contractions, and also by an EEG reading.
Patients are brought back to the recovery area where we continue to monitor vital signs and assess orientation. Nurses review follow-up plans and schedule the next treatment.
What is Electroconvulsive therapy (ECT)?
Electroconvulsive therapy (ECT) delivers a brief electrical stimulation to your brain while you’re under anesthesia. ECT has been shown to help more than 70 percent of patients who use it as part of their therapy.
ECT may be a treatment option for you if medicine or psychotherapy does not work, if they are too slow to relieve your symptoms or if you previously had successful response to ECT treatments.
Conditions treated
ECT may be helpful for treating:
- major depression
- bipolar affective disorder
- schizophrenia
- neuroleptic malignant syndrome
- delirium
More about ECT
ECT is given at the hospital. A psychiatrist, an anesthesiologist and a registered nurse are in the room with you during each treatment. After you are asleep, the psychiatrist will give you a brief electrical stimulation delivered through leads on your scalp. This will cause a seizure in your brain. Your body remains still due to the effects of a muscle relaxer. The nurse will monitor you in the recovery area until you wake up.
The number of ECT treatments varies for each patient. In general, a patient may receive two to three treatments a week for a total of three to 12 treatments. If you need more treatments after the initial cycle, you and your psychiatrist will talk about a schedule.
Related links
Source: Allina Health Mental Health
Reviewed by: Allina Health Mental Health
First published: 9/25/2019
Last reviewed: 9/25/2019