Who might benefit from treatment?
Electroconvulsive therapy (ECT) works best in conjunction with other modes of treatment namely medications and psychotherapy. ECT is the most effective treatment available for depression and other severe mental illnesses; however, in order to remain illness-free it is imperative to continue taking medications.
Who may not be a candidate?
According to the American Psychiatric Association (APA) there are no absolute contraindications to ECT. Certain conditions however put a patient at a higher risk for complications. Some of these conditions are:
- Brain tumors or any condition which elevates the normal fluid pressure of the brain.
- Recent heart attack.
- Recent episode of bleeding into the brain.
- Unstable brain blood vessel abnormality predisposed to bleeding.
Every treatment has side effects and so does ECT. Headaches, muscle soreness and nausea are the most common side effects associated with ECT. These are usually minor, may last a few hours and easily managed with medications given either during the procedure or while in recovery.
ECT may cause transient heart rhythm abnormalities or transient elevations in heart rate or blood pressure. With careful screening of patients, close monitoring during the procedure, and timely administration of medications, complications can be minimized.
Some patients may experience confusion after the procedure which lasts more than a few minutes. Usually this confusion is self-limited and corrects itself within a few hours. Reassurance, frequent reorientation and monitoring are all that is needed for management of confusion.
Memory loss is probably the biggest concern that people have with ECT. ECT may cause problems with loss of memory for events surrounding or preceding the procedure. This problem typically resolves within days to weeks of cessation of treatments. In a minority of patients, memory of remote events may be affected. However extensive research has proven that ECT does not cause permanent brain damage.
The risk of mortality with ECT is the same as any minor surgical procedure and corresponds with the risk of anesthesia. The risk of death from a complication is 1 in 10,000 (0.01%). Certain risk factors are associated with a higher risk of anesthesia and thus higher mortality. These factors are discussed with the patient during their consent to treatment.