Bipolar Disorder and Electroconvulsive Therapy (ECT)

Electroconvulsive therapy, also known as ECT or electroshock therapy, is a short-term treatment for severe manic or depressive episodes, particularly when symptoms involve serious suicidal or psychotic symptoms, or when medicines seem to be ineffective. It can be effective in nearly 75% of patients.

In electroconvulsive therapy, an electric current is passed through the scalp to cause a brief seizure in the brain. ECT is one of the fastest ways to relieve symptoms in people who suffer from mania or severe depression. ECT is generally used only when medicines or other less invasive treatments prove to be unhelpful. It is also used when mood or psychotic symptoms are so severe that it may be unsafe to wait until drugs can take effect. ECT is also often thought to be the treatment of choice for severe mood episodes during pregnancy.

Prior to ECT treatment, a person is given a muscle relaxant and put under general anesthesia. Electrodes are placed on the patient's scalp, and an electric current is applied that causes a brief seizure. Because the muscles are relaxed, the seizure will usually be limited to slight movement of the hands and feet. The patient is carefully monitored during the treatment. The patient awakens minutes later, does not remember the treatment or events surrounding the treatment, and may be briefly confused.

ECT is usually given up to three times a week, typically for two to four weeks. After that, maintenance treatment can continue weekly or monthly, depending on the person's needs.

ECT is among the safest treatments for severe mood disorders, with most risks being related to the anesthesia. Short-term memory loss is a common side effect, although this usually goes away within a few weeks after the treatments have ended, and can be minimized based on how the electrodes are placed on the scalp and other technical aspects of how the procedure is done.

Other possible side effects of ECT include:

• Confusion
• Nausea
• Headache
• Jaw pain
• Muscle aches

These side effects may last from several hours to several days.

About a third of people who have ECT report some memory loss, but this is usually limited to the time surrounding the treatment.

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