My sister was admitted to a hospital yesterday for clinical depression. She has tried several antidepressants to no avail. A doctor who has not treated her is recommending shock therapy. I searched the Web to find information on this subject and could find nothing. I thought shock treatments were archaic. Is this still a valid and effective method for treating depression?
Electroconvulsive therapy (ECT) is a safe and effective treatment for major depression, mania, and certain forms of schizophrenia. Developed almost 60 years ago, and sometimes misunderstood and neglected, it is still a valuable treatment.
In up to 90 percent of cases of major depression, ECT provides rapid relief of serious symptoms like depressed mood, delusions, suicidal drive, poor appetite, and weight loss. For depressed people with psychosis or extensive physiological disturbance (poor appetite, constipation, lack of energy, severe insomnia), it is often given as a first-line treatment. At times, its effect is dramatic and life-saving.
The modern form of ECT is much improved over early versions. The patient is given a short-acting anesthetic intravenously, which induces unconsciousness. A muscle relaxant called succinylcholine (Anectine) is administered.
Electrodes are applied to the head and a measured dose of electrical current generated by a special machine is delivered, inducing a generalized seizure. The seizure is a brain event with little or no bodily expression because of the muscle relaxant. The seizure is the therapeutic event. The patient wakes up some minutes later in a recovery room and rapidly recovers.
The treatment is usually given three times a week — up to six to 12 or more treatments –in in-patient settings, although it can be given to out-patients, too. The treatment can be done even with ill and aged individuals. There are no medical conditions that absolutely preclude treatment.
There is memory loss and even confusion, especially when the electrodes are applied to both sides of the head — as opposed to one side only. But it mostly clears up within two weeks after the end of treatment and completely within months. When confused, patients need to be monitored closely. Some may not recover memory from around the time of treatment. Although critics charge that ECT causes irreversible brain damage, this is not born out by studies or clinical experience. However, ECT involves brief general anesthesia , which always carries a small risk.