What is ECT?

Electroconvulsive Therapy, or ECT, is a treatment that causes the brain to have a generalized, or "grand mal," seizure under medically controlled conditions. It is performed under the guidance of two doctors, a psychiatrist and an anesthesiologist. Each treatment is done while the patient is asleep (with general anesthesia) and takes only minutes to complete.  It is a treatment option for patients who are diagnosed with a range of serious mental illnesses, especially patients with severe depression.

Transportation

Patients planning for outpatient ECT must arrange for transportation to and from the procedure. Due to the effects of general anesthesia, the patient must be accompanied from their ECT treatment by an escort (family, friend or health care professional). A phone number for the escort must be available to the staff. The escort will be instructed when to pick up the patient.

ECT Technology

Our state-of-the-art ECT technology allows treatment with ultra-brief stimulation. Due to the new technology’s more gentle effects on memory, we may be able to provide a more sustainable, long-term maintenance treatment.

Initial Evaluation

A psychiatric evaluation is performed to determine the appropriateness of ECT treatment. Patients also receive a medical evaluation, by a cardiologist, including a physical examination, blood tests and an electrocardiogram (EKG) before beginning ECT.

The Procedure

The number of treatments recommended is based on the individual patient’s needs and responsiveness to the procedure. Patients come two to three times per week and usually receive between 6 and 12 treatments per episode of care. The patient is put to sleep with a short-acting anesthetic. A muscle relaxant is then administered, followed by a low-voltage electrical stimulus to the brain of the patient to cause a seizure. This is theorized to improve the chemical pathways in the brain, permitting an adjustment of nature’s neurotransmitters that affect mood and behavior. The patient is usually fully awake 10 to 20 minutes after falling asleep.

Some patients may have a need for maintenance ECT, as 50 percent of people who respond well to a course of ECT may relapse within six months. Therefore, a maintenance treatment of medications and/or ECT might be advisable. The treatment is administered on the 7th Floor, within the Psychiatric service.  

Potential Side Effects

ECT is considered one of the safest treatment options for medically fragile patients, including the elderly, pregnant women and patients who have limited tolerance to some psychiatric medications. As with all forms of medical treatment, some patients may experience adverse side effects. There is a potential for memory problems, headache or confusion in some patients, and in rare cases, death. Other side effects may include muscle soreness, nausea, and temporary irregularities in heart rate and in a few instances, damage to fragile teeth. Some patients prefer to sleep for a few hours after they return home on treatment days.

For More Information

If you have questions about inpatient or outpatient ECT services, please contact Chrissy Fennell, ECT coordinator, at [email protected] or 202-243-5178.