Shock treatment, now known as electroconvulsive therapy (ECT), is used for severe depression in cases when other treatment has failed. The patient is chronically suicidal, psychotic, cannot eat or function in daily self-care. ECT has a high success rate in helping severely depressed patients, especially when compared with antidepressants.
Desired Effects of ECT
The ECT causes a "clonic-tonic" seizure that may involve one or both hemispheres of the brain. The ECT effectively "resets" the brain, breaking the cycle of the depressive process in part caused by brain chemistry like increased levels of important neurotransmitters, as studied in "Increased Cortical GABA." The neurotransmitters assist the brain in achieving the correct chemical balance for mood. According to "Practice Guideline" 80 to 90 percent of patients with severe major depression show improvement after receiving this therapy.
Memory Loss
In some patients, ECT may cause memory loss for a short time or may cause more lasting memory loss. According to "Synopsis of Psychiatry," around 75 percent of ECT patients agree that memory loss is the worst side effect of ECT. By about six months after ECT, most patients fully recover their memory.
Effect on Central Nervous System
Some ECT patients may temporarily feel nauseated, vomit and have headaches following the treatment. Confusion and delirium may occur, though these effects usually end within half an hour following the shock. Medication is used to lessen these side effects.
Musculoskeletal Effects
In modern ECT, the patient is prepared with medications before the treatment to greatly reduce the possibility of the patient suffering musculoskeletal damage. According to "Synopsis of Psychiatry," it is still remotely possible that a particular patient may suffer a fracture or muscle soreness from the seizure.
Brain Side Effects
No research to date has supported evidence of brain damage from the ECT shocks.
Death from ECT
"Synopsis of Psychiatry" reports that the death rate for ECT is about 0.002 percent per treatment, and is about 0.01 percent per patient. The few times death occurs, it is usually in a patient with severe preexisting cardiovascular problems.
References
- "Practice Guideline for the Treatment of Patients with Major Depressive Disorder, 2nd. ed."; American Psychiatric Association, Work Group on Major Depressive Disorder, Alan Gelenberg, M.D., Arnold Merriam, M.D., Philip Wang, M.D., Dr.P.H. (Consultant); 2000
- "American Journal of Psychiatry"; Increased Cortical GABA Concentrations in Depressed Patients Receiving ECT; Gerard Sanacora, M.D., Ph.D., Graeme F. Mason, Ph.D., Douglas L. Rothman, Ph.D., Fahmeed Hyder, M.D., James J. Ciarcia, M.D., Robert B. Ostroff, M.D., Robert M. Berman, M.D., and John H. Krystal, M.D., March 2003
- "Synopsis of Psychiatry, 9th. ed."; Benjamin J. Sadock, M.D., Virginia A Sadock, M.D.,2003
