Randle McMurphy bites on a block of wood, electrodes are attached to both sides, juice starts flowing, and the seizures begin. After a few weeks, his body is limp and scarred on the forehead.
Studies have shown that ECT is a powerful tool for reducing suicidal thoughts and behaviors.
The film is a good example. One Flew over the Cuckoo’s Nest Randle’s initial procedure was electroconvulsive treatment (ECT) c.1963. The final procedure was called a lobotomy.
No longer are lobotomies performed. ECT does exist, but looks very different from Randle’s 1957 photograph and that of the ECT.
Electroconvulsive Therapy is a safe and effective intervention for people with emotional and mental disorders that are resistant to treatment. It’s highly stigmatized and therefore underused.
This is not the ECT of your grandparents.
Let’s discuss some important and new research.
What is electroconvulsive treatment?
Let’s start with what ECT isn’t: Deep Brain Stimulation (DBS), Transcranial Magnetic Stimulation (TMS),, Transcranial Direct Current Stimulation (tDCS),.
The electroconvulsive treatment is a medical procedure that uses electrical stimulation in order to induce controlled seizures. The patient is placed under general anesthesia.
ECT is used most commonly for treatment-resistant depressions, suicidal thoughts, bipolar disorder, psychosis and catatonia in older adults.
A few quick tidbits…
- One million people in the world suffer from ECT every year.
- Approximately 70% are female patients.
- Over one third of ECT patients is 65 years old and older.
- In some states, it is illegal to use this drug on children or teens.
ECT is a therapy that has been approved by the US FDA. In 2018, the FDA also issued a order that regulates ECT devices. ECT regulation is a top priority in many other countries. The Royal College of Psychiatrists in the UK has set up the ECT accreditation service.
Types and ECT
Two main types of ECT are used in mainstream practice.
- The electrodes are placed in both directions on the head. The aim is to influence the entire brain. It is by far the most common.
- Unilateral: An electrode is placed at the top of the head, and another one on the temple (usually the right). The current is limited to only one side of the head.
There are other techniques, such as the right unilateral ultrabrief pulse.
The electrode placement, treatment frequency and the electrical waveform are all decided with the goal of maximum results and minimal side effects.
A typical initial course of ECT consists of two to three sessions per week, for a total of six to twelve sessions.
How is ECT used?
Let’s look at a few more conditions for which ECT can be used. Keep in mind, ECT is used most often when other treatments fail. It’s also used for quick results.