electroconvulsive therapy

Treatment mainly for severe depression, given under anaesthesia and with a muscle relaxant. An electric current is passed through one or both sides of the brain to induce alterations in its electrical activity. The treatment can cause distress and loss of concentration and memory, and so there is much controversy about its use and effectiveness.

ECT was first used in 1938 but its success in treating depression lead to its excessive use for a wide range of mental illnesses against which it was ineffective. Its side effects included broken bones and severe memory loss.

The procedure in use today is much improved, using the minimum shock necessary to produce a seizure, administered under general anaesthetic with muscle relaxants to prevent spasms and fractures. It is the seizure rather than the shock itself that produces improvement. The smaller the shock administered the less damage there is to memory.

ECT is increasingly being seen in the USA 1994 as the most effective treatment available for severe depression, when all other therapies have failed. The American Psychiatric Association maintain that it can help more than 80% of severely depressed patients.