Electroconvulsive Therapy (ECT), a Time Tested Machine in Psychiatry

 Have you been suggested for an Electroconvulsive therapy (ECT) by your psychiatrist and you are worried about it? Then this post will help to ease your anxiety.

ECT is a medical procedure that involves passing small electric current (very small current- nowadays), through the brain to induce brief seizures.

ECT is used in psychiatry to treat severe mental disorders, such as major depression, bipolar disorder, schizophrenia, and catatonia. ECT can be a lifesaving treatment for some patients who do not respond to other therapies or medications. It can also be procedure of choice in pregnant lady with severe depression, where medications cannot be used or are ineffective. 

Now days, the procedure is done under anesthesia (along with muscle relaxation) and in most cases patient does not even have the memory of the procedure. A smooth transition is ensured by treating psychiatrist and the anesthesiologist. The treating Psychiatrist ensures that the patient receives the correct dose of electric stimulation to the brain. To give an idea about stimulation parameters in an ECT machine, the current is set at 0.8 Ampere, which is typically delivered for 0.2 to 5.9 seconds and has total power between 2.7 Joules -160 Joules (assuming patient impedance to be 220 Ohm). The electric currents are delivered through electrodes attached to the scalp. The procedure usually takes about 10 minutes, and the patient is monitored for recovery for another hour.

ECT works by altering the brain's chemistry and activity, which may help restore normal mood and functioning. The exact mechanism of how ECT works is not fully understood, but research suggests that it may increase the levels of certain neurotransmitters, such as serotonin and dopamine, that regulate mood and cognition. Recent research have indicated that ECT may also stimulate the growth of new brain cells and connections, which may improve brain plasticity and resilience.

ECT is generally safe and effective when performed by qualified professionals in a proper setting. However, like any medical procedure, ECT has some risks and side effects. The most common side effect of ECT is short-term memory loss, which usually improves within weeks or months after the treatment. Some patients may experience longer-lasting or permanent memory loss, especially for events that occurred around the time of the treatment. Other possible side effects include headache, nausea, muscle soreness, confusion, and agitation.

ECT does not prevent future episodes of illness, and patients may need to continue taking medications or undergoing psychotherapy after ECT. Some patients may benefit from maintenance ECT, which involves receiving periodic treatments to prevent relapse, which are usually given on monthly basis.

ECT is a controversial treatment that has been stigmatized and misunderstood by the public and the media. Many people associate ECT with abuse, coercion, and torture, based on outdated or inaccurate portrayals of the procedure. However, in modern ECT no patient is administered this procedure without anesthesia or consent, or with high doses of electricity that caused severe brain damage and death.

ECT is not a treatment for everyone, and it should be considered only after careful evaluation and consultation with a mental health professional or psychiatrist. ECT in India, are now performed with informed consent from the patient or their legal representative, and with respect for their rights and dignity. With the advent of safe stimulation protocol ECT have now become a part of a comprehensive treatment plan that addresses the patient's physical, psychological, social, and spiritual needs.

So, for more information about ECT you can consult your treating psychiatrist.


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