What is Electroconvulsive Therapy?
Electroconvulsive therapy, also known as Electroshock Therapy or simply Shock Therapy is a treatment used to cure psychiatric disorders. In electroconvulsive therapy artificial seizures are induced with the help of electric shocks which help in curing various psychiatric disorders. Electroconvulsive therapy was first used in 1938 and was later placed in the high risk treatment category by United States Food and Drug Administration (FDA) in 1976.
Even though electroconvulsive therapy was widely and sometimes indiscriminately used in the 50’s and 60’s, its use declined in the later decades. It was in part due to the discovery of more effective drugs to treat various psychiatric disorders like mania and depression but the movie “One Flew Over The Cuckoo’s Nest” also played a part in it, in which Jack Nicholson played the part of a patient who is repeatedly given electroconvulsive shocks.
How Was Electroconvulsive Therapy Discovered?
As the story goes, Ugo Cerletti- an Italian professor of neuropsychiatry; after watching pigs in slaughter houses developed the idea of using electroconvulsive therapy on humans. Electric shocks were given to pigs to make them unconscious, making the slaughter easier. The idea of inducing shocks to treat mental illness was not new by any means. Even Benjamin Franklin wrote about it. But usually those shocks were produced by various chemicals like camphor and metrazol. Cerletti along with his colleague Lucio Bini used electric shocks on a human patient in 1938.
Who is Administered Electroconvulsive Therapy?
Electroconvulsive therapy treatment is only given to those patients who resist all other kinds of treatments. Electroconvulsive therapy is the last line of treatment. It is only used when all other options fail.
How Effective Is Electroconvulsive Therapy?
The effectiveness of electroconvulsive therapy is only about 50% according to various researches and experimentations. Even those that respond cannot be assured of the effectiveness as half of those relapse within twelve months of receiving electroconvulsive therapy.
How is Electroconvulsive Therapy Done?
Electroconvulsive therapy is usually done over a period of two weeks where the treatments can be six to twelve in number. The whole procedure takes less than half an hour. Two types of procedures are usually used to administer electroconvulsive therapy:
Unilateral Electroconvulsive Therapy Procedure
In this type of electroconvulsive therapy, electrodes are placed on the same side of the head which usually doesn’t cause memory loss and lets the patient keep his memories though it is less effective than bilateral electroconvulsive therapy.
Bilateral Electroconvulsive Therapy Procedure
In bilateral electroconvulsive therapy electrodes are placed on both the sides of the head which causes loss of memory but it seems to be more effective.
In both the cases, a general anesthesia is administered and the patient is given muscle relaxants through an IV prior to therapy so as to prevent broken bones and vertebral column.
Then shocks are given to the patient through those electrodes. The number and intensity of shocks differ from patient to patient.
How Does Electroconvulsive Therapy Works?
It is not actually known how or why electroconvulsive therapy works where traditional medicines don’t, even though we do know that it changes the pattern of blood flow in the brain. Different people believe different theories ranging from some saying that its works just like anti-depressant medications while there are others who say that it releases some special chemicals in the body that help in curing the disorder while still others believe that it doesn’t actually cures the disorder but rather creates an illusion of wellness which the brain believes because it gets confused after the use of electroconvulsive therapy.
Electroconvulsive Therapy is Most Useful in the Treatment of Which Medical Conditions?
Electroconvulsive therapy is actually used as a last resort to cure a number of disorders. Some of them are as follows:
Major Depressive Disorders
Electroconvulsive therapy is used to cure a number of depressive disorders such as acute depression due to Parkinson’s disease, Huntington’s chorea and multiple sclerosis. Electroconvulsive therapy is used when all other treatments fail or there is a risk of a person committing suicide.
Psychosis is a condition of acute depression, where a person is disconnected with reality and sometimes even refuses to eat. Electroconvulsive therapy is used in this condition also.
Electroconvulsive therapy is also used to treat catatonia which is basically a state in which the person neither moves nor talks and is said to be gone into a catatonic state.
Electroconvulsive therapy can also be used for people suffering from severe mania in which the patient gets highly agitated or euphoric for no apparent reason whatsoever. It is also characterized by poor decision making and risky and dangerous behavior, substance abuse etc.
Those patients who are suffering from schizophrenia and are showing little to no response to antipsychotics can be treated with the help of electroconvulsive therapy.
Electroconvulsive therapy can also be used to treat some other disorders such as dementia etc.
What are the Benefits of Using Electroconvulsive Therapy?
Electroconvulsive therapy may be a risky treatment and it may be used only when all other options fail, but there are certain benefits attached to it as well. Some of the benefits of Electroconvulsive therapy are mentioned below:
- During pregnancy, electroconvulsive therapy is actually considered the least dangerous option. It is relatively safe during all three trimesters of pregnancy if some precautions are taken.
- Electroconvulsive therapy is particularly used in patients where it has proved beneficial or effective in the past.
- Electroconvulsive therapy is beneficial when all other options fail in some of the disorders.
- When the patient proves resistant to antidepressants, electroconvulsive therapy is least risky option left.
- In people who cannot use regular drugs due to their intolerance to it.
What are the Adverse Side Effects of Electroconvulsive Therapy?
Apart from the brain, the physical adverse effects of electroconvulsive therapy are not severe and are very similar to those of general anesthesia. Some of those adverse side effects are as follows:
Short-Term Side Effects of Electroconvulsive Therapy
One of the side effects of Electroconvulsive therapy is that the person may become confused when he wakes up after electroconvulsive therapy. He may also experience short term memory loss. Disorientation is common in patients for a while after electroconvulsive therapy. They may also experience some side effects like soreness due to the use of muscle relaxants. Headache and nausea are also quite common. Patients may also have difficulty in learning new stuff during electroconvulsive therapy but it usually goes away after the period of treatment is over.
Long-Term Side Effects of Electroconvulsive Therapy
Some people claim to have had permanent brain damage after electroconvulsive therapy even though doctors believe that the shock waves used for the therapy are not high enough in intensity to be able to cause brain damage. Memory loss though recovered in most cases can be permanent in some people. Electroconvulsive therapy if combined with deep sleep therapy may lead to hypoxia or anoxia which in turn, can cause brain damage. Electroconvulsive therapy has also been known to cause cognitive impairment.
What are the Legal Ramifications of Electroconvulsive Therapy?
Even though there are different laws in different countries, WHO (World Health Organization) advises to use electroconvulsive therapy after the informed consent of the patients which basically means that the patient should be told about all the ramifications, both good and bad, before he or she is asked to make a decision. The doctor may go on with the electroconvulsive therapy only after the patient gives his or her consent which he or she can withdraw at any time during the course of the procedure. If the patient is unable to make a decision then their legal guardians will make the decision based on the patient’s wishes.
How is Electroconvulsive Therapy Different Today From Before?
Even though it is still a risky procedure, present day electroconvulsive therapy differs a lot from the earlier one as there have been many changes in the technology. Some of them are:
- Nowadays muscle relaxants are used before electroconvulsive therapy to prevent broken bones which weren’t used before.
- In earlier times a large number of electroconvulsive therapy treatments were given to patients, sometimes as many as 100 treatments while much less treatments are used nowadays.
- The intensity of the shocks given during electroconvulsive therapy was also greater than today.
So, these are some of the things which have made electroconvulsive therapy a much safer option. But before you make a decision, you should go through all the pros and cons so that you can make a truly informed decision.