Treatment Overview

Electroconvulsive therapy (ECT) is a procedure used to treat severe depression. It may be used in people who have symptoms such as delusions, hallucinations, or suicidal thoughts or when other treatments such as psychotherapy and antidepressant medicines have not worked. It is also used for other psychiatric and neurological conditions, such as schizophrenia and Parkinson's disease.

Before ECT, you are given anesthesia to put you in a sleepy state, and you are given medicines to relax your muscles. Then an electrical current is briefly sent to the brain through electrodes placed on the temples or elsewhere on the head, depending on the condition and type of ECT. The electrical stimulation, which lasts up to 8 seconds, produces a short seizure. Because of anesthesia, the seizure activity related to ECT does not cause the body to convulse.

It is not known exactly how this brain stimulation helps treat depression. ECT probably works by altering brain chemicals (similarly to medicines), including neurotransmitters like serotonin, natural pain relievers called endorphins, and catecholamines such as adrenaline.

ECT treatments are usually done 2 to 3 times a week for 2 to 3 weeks. Maintenance treatments may be done one time each week, tapering down to one time each month. They may continue for several months to a year, to reduce the risk of relapse. ECT is usually given in combination with medicine, psychotherapy, family therapy, and behavioural therapy.