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Electroconvulsive therapy (ECT)

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ECT is a form of medical treatment for severe depression, bipolar disorder, and psychotic illnesses such as 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, occasionally some may need 20 to 25. Treatments are usually given 2 to 3 times a week.

How does ECT work?

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.

Is there evidence that ECT works?

There is now a clear body of scientific evidence that ECT is effective in improving depressive and psychotic symptoms. 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.

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 lasting for some weeks after treatment. 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 and related issues.

Living with mental illness

The SANE fact sheet and guide to treatments for mental illness explains how they work, including clinical care, support in the community and helping yourself.

SANE's Schizophrenia DVD Kit is available for purchase. It features people who've experienced mental illness, and their carers, talking about what has helped them. The SANE Guide to Schizophrenia and other Psychotic Illness is included.

Last updated: 29 May, 2017

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