Electroconvulsive Therapy (ECT)

What is Electroconvulsive Therapy (ECT)

Electroconvulsive therapy is a procedure that uses electricity to change the brain chemicals that send messages between brain cells (neurotransmitters). In this procedure, small electrical conductors (electrodes) are attached to the scalp on only the right side of the head (unilateral) or on both sides of the head (bilateral).

Your health care provider uses a machine to deliver an electric shock to the electrodes. The electric current passes through the electrodes to your brain, causing a controlled seizure that lasts 1–2 minutes. You will not be aware of the seizure. You also will not be in pain or feel the electric shock.

ECT can be used to treat certain mental health conditions, including depression, bipolar disorder, and schizophrenia. You may have this therapy if other treatments have not helped. This procedure may need to be repeated several times until your symptoms improve.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.
• Whether you smoke, drink alcohol, or use recreational drugs.

What are the risks of Electroconvulsive Therapy?

Generally, this is a safe procedure. However, problems may occur, including:

• Headache.
• Muscle pain.
• Confusion.
• Nausea.
• Muscle aches.
• Changes in blood pressure or heart rhythm during treatment.
• Allergic reactions to medicines.
• Temporary short-term memory loss. This usually goes away several days to weeks after the procedure.

What happens before the Electroconvulsive Therapy?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Exams

• You will have a physical exam. This may include blood tests and a test to record your heart’s electrical activity (electrocardiogram,or ECG).
• You may have a psychiatric exam to make sure you understand what will happen during the procedure and agree to have it (informed consent).

General instructions

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines before your procedure if your health care provider instructs you not to.
• Plan to have someone take you home from the clinic or hospital.
• Plan to have someone stay with you for 24 hours.

What happens during the procedure?

• You will be given the following:
  • A medicine to help you relax (sedative).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine to relax your muscles (muscle relaxant).
• An IV tube will be inserted into one of your veins.
• The electrodes will be placed on one side or both sides of your head.
• Your health care provider will stimulate your brain with short electrical pulses to start a controlled seizure.
• The electrodes will be removed.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• Do not drive for 24 hours if you were given a sedative or a muscle relaxant during your procedure.

Electroconvulsive Therapy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Headache.
• Confusion.
• Nausea.
• Muscle aches.
• Temporary short-term memory loss.

Follow these instructions at home:

• Continue to follow your regular treatment plan for your mental health condition as told by your health care provider. ECT does not cure your mental health condition.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do notdrive for 24 hours if you were given a sedative or a muscle relaxant during your procedure. Ask your health care provider when it is safe for you to drive.

Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Your symptoms do not improve after several treatments.
• Your symptoms get worse.
• You have memory problems that last more than two months.

Get help right away if:

• You have thoughts of hurting yourself or others.

If you ever feel like you may hurt yourself or others, or have thoughts about taking your own life, get help right away. You can go to your nearest emergency department.