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What is electroconvulsive therapy (ECT)?

ECT is a form of medical treatment for major depression, bipolar disorder and psychotic illnesses related to schizophrenia.

It may be recommended when symptoms are severe or other forms of treatment are ineffective. A carefully-controlled electrical current is passed through the brain, affecting the brain’s electrical activity and producing an improvement in depressive and psychotic symptoms.

When is ECT prescribed?

For some people, other forms of treatment such as medication and counselling have little or no effect on the symptoms of depression or psychosis. This is particularly concerning where symptoms are causing severe distress and the person may even be suicidal. In these cases, ECT seems to be especially helpful, with over 80% of people with depression who receive it reporting an improvement.

How is ECT given?

A general anaesthetic is given first, and then a small electric current is passed between two electrodes placed on the scalp.

On waking, the person will have no memory of what followed administration of the anaesthetic. Treatment is typically repeated a number of times and while most people show some improvement after 3 to 4 sessions, it takes on average 9 treatments to achieve recovery and occasionally some may need up to 25. Treatments are usually given 2 to 3 times a week.

Does ECT work and how?

There is now a clear body of scientific evidence that ECT is effective in improving depressive and psychotic symptoms. The brain works through complex electrical and chemical processes. These are affected by mental illnesses, so that they don’t work properly. Like medication, ECT works on these processes so that they operate more normally again and symptoms are reduced.

Reducing Relapse

To make the return of symptoms less likely, medication is usually given towards the end of the course of treatments; counselling and rehabilitation should also be provided. Some people need occasional continued ECT treatment, spreadout from around once a week to once a month.

Is it safe? What about side-effects?

ECT is regarded as a very safe treatment, with no evidence of long-term damage to brain functions, such as reasoning and creativity for example. It is always performed under the direct supervision of a psychiatrist, and an anaesthetist and nurses also assist.

A common and significant side-effect, however, is memory impairment. Many people report difficulty with memory which usually clears up shortly after the end of treatment. For some it may persist for a while longer. However, this effect is generally mild and improves with time. It is important that the treating doctor clearly and frankly explains these negative as well as positive effects with the person before treatment begins. Full information about treatment with ECT and legal rights should always be provided and written consent is usually required.

How do I find out more?

It is important to ask your doctor about any concerns you have.

SANE Australia also produces a range of easy-to-read publications and multimedia resources on mental illness including:

The SANE Guide to Medication and other Treatments
Explains how all the different aspects of treatment work, by looking at clinical care, medication, support in the community and helping yourself.

The SANE Guide to Depression
Helps people diagnosed with depression and their family and friends by explaining what it means to have depression, the treatments available and what a person can do to help themselves.

Speaking From Experience: Depression (SANE Guide & Video 43 mins)
People who've experienced depression and their carers talk about the things which have helped them cope better.

The SANE Guide to Bipolar Disorder
Helps people diagnosed with bipolar disorder and their family and friends by explaining what it means to have this diagnosis, examining effective treatments and what family and friends can do to help.

The SANE Guide to Schizophrenia and other Psychotic Illness
Helps people diagnosed with schizophrenia, their family and friends by explaining what it means to have this diagnosis, examining effective treatments and what family and friends can do to help.

To order visit the SANE Bookshop at www.sane.org or call 1800 18 SANE  (7263)

SANE Australia . . . Meeting the challenge of mental illness
ECT - Electroconvulsive Therapy

©SANE Factsheet 25
This Factsheet may be freely downloaded, copied and distributed on condition no change is made to the contents. SANE Australia is not responsible for any actions taken as a result of information or opinions contained in the Factsheet. SANE Australia is a business name of Schizophrenia Australia Foundation.
[Version English, 2006]

Factsheet based on Electroconvulsive Therapy: An Australasian Guide, Australian Postgraduate Medicine www.vmpf.org.au