A Safe & Effective Treatment
Electroconvulsive therapy (ECT) is among the safest and most effective treatments available for depression. During ECT, electrodes are placed on the patient’s scalp and an electrical current is passed through the brain, triggering a brief seizure. This is a simple and generally well tolerated therapy that has been used in the US since the 1940s.
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Misconceptions About ECT (ECT History)
There are persistent misconceptions about ECT based on early treatments in which much higher doses of electricity were used and patients were not anesthetized, which led to significant memory loss, fractured bones, and other serious side effects. Many procedure risks and side effects were related to the misuse of equipment, incorrect administration, and improperly trained staff. The way we perform ECT today is much safer and more effective.
All patients are under general anesthesia and monitored closely by an anesthesiologist and a psychiatrist. Although ECT still has some potential side effects, we now use smaller amounts of electricity in a very controlled setting to achieve the most benefit with the fewest possible risks. Your doctor will describe all the details during your assessment.
Who Is a Candidate for ECT?
ECT may benefit individuals with certain mental health disorders including depression, bipolar disorder, and schizoaffective disorders. ECT is often an option for patients who do not see improvements with other treatments such as medications and psychotherapy. ECT is used during pregnancy when medications can't be taken because they might harm the developing fetus and is often used in older adults who can't tolerate the drug side effects.
How Does ECT Work?
A series of ECT consists of approximately 8–12 treatments. Treatments are done three times a week for about five weeks. During this time, patients cannot work, drive, or operate machinery. Companionship is required 24 hours due to the possible confusion during treatment. Depending on current medications, patients may have to stop some medications two to five days prior to ECT.
Following a series, some patients find it useful or necessary to continue with periodic maintenance treatments in order to maintain the benefits of ECT. Maintenance treatments may be spaced anywhere from once a week to a few times a year, depending on the individual.
What Can I Expect the Day of My Treatment?
Because general anesthesia is used for ECT, no food can be eaten for eight hours prior to treatment. No gum, candy, or smoking for six hours prior. Water is okay up to four hours before treatment.
Upon arrival at the clinic, the patient will be greeted and checked in by one of our office staff. A nurse will meet with them to review medications and place an IV. Patients may receive a shot of Robinul at this time, which dries up secretions making anesthesia safer.
During treatment, a small amount of electrical current is passed though the brain triggering a brief therapeutic seizure. When treatment is complete, the patient will be wheeled into the recovery room, where they will wake up within a few minutes while being monitored by a nurse. Patients are typically in the recovery room for 20–40 minutes prior to being discharged.
What Are the Side Effects of ECT?
Confusion—Patients may experience a period of confusion that can last from a few minutes to several hours. Patients may be able to return to normal activities right away, or they may need to rest for several hours after treatment. Rarely, confusion may last several days or longer. Confusion is generally more noticeable in older adults.
Memory loss—ECT can affect memory in several ways; patients may have trouble remembering events that occurred before treatment began. It may be hard to remember things in the weeks or months leading up to treatment. Patients may also have trouble recalling events that occurred during the weeks of their treatment. And some people have trouble with memory of events that occur even after ECT has stopped. These memory problems usually improve within a couple of months.
Physical side effects—On the days a patient has an ECT treatment, they may experience nausea, vomiting, headache, jaw pain, muscle ache or muscle spasms. These are generally side effects of the anesthesia being administered but can be treated with medications.
Medical complications—As with any type of medical procedure, especially one that involves anesthesia, there are risks of medical complications.
What Does Electroconvulsive Therapy Cost?
ECT is covered by most insurance companies. Coverage for ECT is based on medical necessity. Preauthorization might be requested by your insurance company. The amount covered varies depending on the insurance company. We have an insurance specialist in our office who will come to an agreement with the insurance company regarding coverage prior to treatment beginning. Copays for ECT are typically higher than a regular office visit, but vary depending on the insurance coverage.
If insurance does not cover ECT we do have a self-pay rate for each treatment. For more information about insurance coverage and financial responsibility please contact our office.
Meet Our ECT Patient
Chris struggled with mixed bipolar disorder episodes—a dangerous mix of severe depression and mania that keeps him hyper-focused on thoughts of suicide. He tried numerous medications and lifestyle changes, but wasn't responding well to either. After his sixth attempted suicide, he was referred to the Treatment Resistant Mood Disorders Clinic and tried electroconvulsive therapy (ECT) to stabilize his moods. ECT gave him the chance to be a dad and husband again.