Electro Convulsive Therapy (ECT)

What is ECT?

Electroconvulsive Therapy (ECT) is a safe and effective medical treatment for certain psychiatric disorders. ECT treatment is also called “electrical stimulation to the brain”, “electroshock therapy” or “shock therapy”.

ECT has been used for the treatment of many psychiatric disorders since 1938. Since then, this technique has been developed to increase its effectiveness and reduce its side effects. Before the patient to be applied ECT, some necessary blood tests are performed, heart radiography, brain electrode and MR are taken.

Whether there is any harm in taking anesthesia and applying ECT is evaluated by Internal Medicine, Anesthesiology and Neurology specialists,

How is ECT applied?

In a treatment room where an anesthesiologist and a psychiatrist are present, anesthesia drugs that provide muscle relaxation and sleep are primarily given to the patient lying on the stretcher.

Then, electrical current is given for a few seconds from two electrodes placed on the patient’s forehead. With this current, a rhythmic electrical activity occurs in the brain and brain chemicals are released. The procedure takes about 5 minutes, after the process is over, the treatment team will be with the patient for about 15-20 minutes while the patient wakes up completely.

Does ECT damage the brain?

There is no scientific evidence available that ECT causes brain damage. In case of brain damage, no increase in enzymes and proteins in the blood circulation was observed in patients who were applied ECT. In experiments in animals, no damage was observed in the brain tissue examined after ECT-triggered seizures, and no structural changes were observed even months after the seizure. The increase in brain temperature during ECT is one tenth of a degree, so electricity does not damage the brain tissue.

Does ECT cause permanent memory loss?

Memory defects monitored after ECT usually disappear completely within a year. ECT does not reduce learning skills, on the contrary, it makes learning easier with the disappearance of depression. However, in some patients, it may take 6 months to 1 year to recall personal memories just before ECT. However, forgetfulness in psychiatric patients is observed more frequently due to inadequate illness, drug side effects or aging..

Why does my doctor recommend ECT?

With the use of new drugs, the rate of need for ECT has decreased, but ECT is still the most effective treatment for many patients. In some cases, the response to drugs is insufficient, in some cases the desired dose cannot be reached due to the side effects of the drugs, and in some cases, it is desired to achieve rapid improvement that only ECT can provide due to the patient’s risk of suicide.

How many ECTs are applied for treatment?

ECT is a form of treatment usually applied 2-3 times a week. General application is 6-12 ECT in one cycle.

Is ECT a safe treatment?

In a study conducted in the USA in 1999, it was determined that there was a death case in 50,000 ECT application, which was much lower than the frequency of maternal death at birth. In other studies, it was found that death rates due to heart attack and other reasons were similar in patients with depression who received and did not receive ECT. With modern anesthesia techniques, ECT has become even more reliable today.

Is ECT painful for the patient?

There is no similar aspect to the ECT scenes or electric chair images seen in the movies and the real ECT application. ECT is not painful, it is not punishment for the patient. Most patients who had been applied ECT found sitting in the dentist’s chair more stressful than ECT.

Does ECT cure?

A certain improvement is observed in 90% of patients who undergo ECT. Many patients maintain their well-being for months after ECT. After ECT, treatment is usually continued with the use of medication. However, in some mental illnesses, complete recovery may not be seen despite strong treatments. In this case, the aim is to achieve the best possible and patient’s most functional condition.

In which diseases ECT can be applied?

The disease state in which ECT is most frequently applied is severe depression. In this disease, the person experiences intense sadness, anguish, loss of attention, appetite and sleep disturbances, and may have suicidal thoughts. ECT can also be used in mania and schizophrenia.

What are the side effects of ECT?

While waking up after ECT application, the patient may experience a gradually alleviating confusion and inability to recognize his surroundings within the first hour. There may be slight difficulty remembering details of recent events, dates, and phone numbers during the first months. However, this situation disappears in months. The effect of ECT is independent of experiencing forgetfulness. ECT is not a memory erasing technique. With the new devices we use in our clinic, the duration of the electric current used in the treatment is very shortened and this side effect is minimized.

William Lindberg
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