Electroconvulsive Therapy (ECT) Effectiveness and Side Effects for Clinical Depression Treatment

Clinical depression is a constant and prolonged sense of despair and hopelessness. People suffering from it face difficulty working, studying, eating, sleeping, and enjoying life. The symptoms can be acute, chronic, or repetitive.

While the established treatments for this condition range from psychological therapy to medication, a non-conventional and rather controversial treatment called Electroconvulsive Therapy (ECT) is also gaining ground as an effective remedy.

What is ECT?

To put it simply, ECT is a procedure in which pulses of electric current are sent through the patient’s brain.

This external electric current results in a brief but intense surge of electrical activity in the brain that works to cure some mental conditions, including clinical depression.

How is ECT Performed?

Before the ECT procedure is started, the patient is put to sleep under the effect of general anesthesia. A muscle relaxant is also administered.

Electrodes are then placed on the patient’s scalp, and a carefully calculated and finely controlled electric current is passed through them. This current passes through the brain of the patient, causing them to have a short seizure.

However, as the patient is under the effects of general anesthesia and muscle relaxants, the seizure remains contained inside the brain and just a little movement is observed in the hands and feet.

All the vital signs and crucial parameters of the body are carefully monitored throughout the ECT session.

Once the session ends, the patient wakes up after a few minutes and has no memory of the treatment as well as the events immediately preceding it. Some patients might also feel confused after the session, a state that typically only lasts a few minutes.

The procedure is generally performed two to three times a week, over two to four weeks.

Concerns Surrounding ECT

Is ECT effective? Or even safe? What are its known side effects? These are some of the questions that come to mind if you are considering letting a doctor attach an electrode to your head and bombard your brain with a bunch of electrons.

All those concerns are magnified by looking at the past of ECT, which is full of incidents when medics performed this procedure without the patients’ consent. There are also allegations that militaries used prisoners of war as subjects of experiments related to ECT.
Let’s see what experts now say about the effectiveness of this procedure and what are some of the risks/side effects related to this treatment.

Effectiveness of ECT

Dr. Max Fink published a review of various studies into ECT in Psychiatric Times. It is a lengthy report to read, so here are the key findings that you need to know:

  • ECT, when done properly, can serve as an effective treatment for patients suffering from more severe forms of depression. The effectiveness of this treatment has little impact on the results previously obtained in the same patients with other treatments.
  • The effectiveness of ECT is more pronounced in patients with treatment-resistant depression, a form of depression that cannot be cured by adequate use of drugs.
  • ECT effectively and quickly relieves vegetative features, depressed mood, suicide risk, and psychosis in severely depressed patients.
  • ECT is a very effective intervention for patients preoccupied with suicide.
  • It is necessary to carry on ECT as a routine medical procedure even after the patient has been cured. Rapid relapse is the principal risk, and it can only be avoided by follow-up and medications.

Dr. Fink further noted in his report that there is a need for further assessment of treatment options to continue after successful ECT. Antidepressants, atypical antipsychotics, and mood-stabilizers are to be prescribed after the therapy to sustain the ECT results.

Without proper follow-up, ECT is more of a symptomatic treatment than a permanent cure.

Some Recent Statistics About ECT

Before we discuss the risks and possible side effects of ECT, here are some recent statistics about this treatment gathered and analyzed by StuffThatWorks.health. Out of all the patients who tried ECT, the results of the treatment were found to be:

  • Extremely well for 30% of the cases.
  • Very well for 38% of the cases.
  • Fairly well for 28% of the cases.

With that said, let’s see what the possible side effects of ECT are.

Side Effects of ECT

In the U.S., ECT apparatus is classified as Category III medical equipment. It means that the patient (or their caretaker if the patient is incapacitated) must be made aware of the

following before the use of this treatment:

  • The possible benefits and risks of the ECT.
  • The possible benefits and risks of alternative treatment.
  • The possible risks of not having any treatment.

If the patient consents to receive ECT after knowing all this, only then the procedure can be performed.

The possible side effects of ECT include:

1. Confusion

Right after the treatment, when the patient wakes up, they can experience confusion. It typically lasts a few minutes to a few hours, but there have been cases of this confusion lasting several days in some patients.

Some patients might not know where they are and why they are there. These effects are more pronounced in aged patients.

2. Amnesia

Some of the patients cannot remember the events just before the treatment. In some people, this can range to several weeks, months, or even years before the treatment. This condition is medically known as retrograde amnesia. Some patients might also not remember the events that took place during the weeks of the treatment.

However, this effect is not permanent, and the memory situation improves significantly.

3. Physical Unrest and Pain

Some patients might experience nausea, jaw pain, headache, and muscle ache on the days of the treatment. It can last for a few days after the treatment in some cases.

This problem is not very severe and can be mitigated with medications.

4. Anaesthesia-Related Complications

As with any other medical procedure that involves the use of anesthesia, ECT can also lead to some complications. For example, during the procedure, when the patient is under the effect of anesthesia, heart rate and blood pressure might go up.

These effects can be more prominent in patients with heart conditions. Patients with serious conditions might even be rendered unfit for receiving this treatment.

In Conclusion

According to the office of the Surgeon General of the U.S., the doctor needs to make the patient (or their caretaker) aware of the possible risks and benefits of the ECT procedure before applying it for treatment.

Even though ECT has proven to be effective in numerous cases, a conclusive study that definitively has established it as a viable treatment regime for clinical depression has yet to come.