Electro-Convulsive Therapy

Electro-convulsive therapy (ECT) is a modern and currently the most effective therapeutic method for treating severe depressive and psychotic illnesses. It is scientifically recognised, highly effective, safe and has very few side effects relative to the severity of the treated disorders.
 

Using a short-term anaesthetic, the brain is stimulated for a few seconds with very short-lived electrical impulses via electrodes on the scalp. If administered several times at intervals of several days, the procedure leads to a complete regression or at least a significant improvement in the majority of patients. The treatment leads to an improved interaction of different brain regions which were previously altered by the disease.

ECT can be considered for severe depressive, manic, psychotic and catatonic (convulsive) disorders, as well as for some less common disorders. We use it if one of the following situations is also present:

• Rapid, definitive relief is urgently needed due to the severity of the psychiatric illness
• Poor response to psychotherapeutic drugs or a good ECT response known from previous experience
• Intolerability or severe side effects of pharmacotherapy
• The patient expressly requests treatment

The effectiveness of ECT is well supported by studies. At the same time, it is a very safe treatment method that is particularly suited for the treatment of older patients.

Possible side effects

Numerous studies show that the treatment does not cause any damage to nerve tissue. Some patients temporarily experience so-called cognitive impairments after ECT, i.e. impaired thinking processes, most often in terms of learning or memory disorders. While memories of past events are rarely impaired, memory gaps may occur, such as gaps in memory with regard to the current treatment. Naturally, this unsettles the patients. Relatives can provide reassuring support at this stage.

In this context, three aspects are important:

• For the average patient group, ECT leads to a significant improvement in cognitive abilities. This is obvious since cognitive impairments are a frequent side effect of mental illness and will be reduced with successfully using ECT.
• If patients experience cognitive impairments as a side effect of the treatment, these problems usually subside completely within days to a few weeks. Rarely do they persist as insular memory gaps over a longer period of time. A complete loss of memory does not occur.
• Numerous studies using a wide variety of methods have shown no evidence of damage to brain tissue by ECT. On the contrary, new scientific findings indicate that some mental illnesses cause brain tissue to shrink and that this process is reversed by ECT. By releasing nerve growth hormones, the therapy leads to the formation of new nerve cells, their contact points and the pathways connecting them.

Temporary, easily treatable side effects such as headaches, muscle aches, dizziness and nausea can be treated symptomatically or resolve spontaneously. Under an ECT, a depressive mood can change into a manic mood. In this case, the treatment can still be continued since ECT is also effective against manic episodes.