Electroconvulsive therapy (ECT) has long been the last stop for individuals when all other treatment seems to fail. ECT has also long had the reputation and perception of being a barbaric treatment. Although anesthesia now makes the procedure itself painless for patients, it still involves the act of shocking the delicate electrical systems of the brain to, in essence, produce seizures.
After 60 years of use, ECT is still the most controversial psychiatric treatment. In the U.S. during the 1940’s and 50’s, the treatment was administered mostly to people with severe mental illness. This is when ECT developed its negative associations, and for good reason, because the treatment was primitive and ripe with painful side effects both during and as a result of the procedure. Much of the current controversy surrounding ECT revolves around its effectiveness vs. the side effects, the objectivity of ECT experts, and the recent increase in ECT as a quick and easy solution, instead of long-term psychotherapy and hospitalization.
Today, common side effects of ECT include headaches, muscle pain, nausea, confusion, and memory loss ranging from moderate to severe. Because of the side effects, some researchers recommend that ECT only be used as a last resort. It is also unclear whether or not ECT is effective. In some cases, the numbers are extremely favorable, citing 80 percent improvement in severely depressed patients, after ECT. However, other studies indicate that the relapse is high, even for patients who take medication after ECT. Some researchers insist that no study proves that ECT is effective for more than 4 weeks.
Today, ECT is administered to roughly 100,000 people a year, and it occurs primarily in general hospital psychiatric units and in psychiatric hospitals. It is generally used in treating patients with severe depression that have been resistant to antidepressants and other treatment. ECT is also used with some suicidal patients who cannot wait for antidepressant medication to take effect.
According to the research, the following groups of people or types of situations may benefit from the treatment of ECT: when a patient’s depression is resistant to antidepressants; when other medical ailments prevent the use of antidepressants; when a patient refuses food and that leads to nutritional deficiencies; when a patient is catatonic; when treating patients who have a severe risk of suicide; when a need exists for rapid treatment response such as in pregnancy; when treating bipolar depression and mania; and when treating severe psychosis and schizophrenia.
During the last few decades, researchers have been attempting to identify the effectiveness of ECT, to learn how and why it works, to understand its risks and adverse effects, and to determine the best treatment technique. The nature of ECT, its history of abuse, unfavorable medical and media reports, and testimony from former patients all contribute to the debate surrounding its use. Research should continue, and techniques should be refined to maximize the efficacy and minimize the risks and side effects resulting from ECT.