UPDATE ON ELECTROCONVULSIVE THERAPY (ECT)

Is ECT Different Today Than In the 1930's?
For many years Electro-Convulsive Therapy was in disfavor. Today it is being used again to treat severe depression, bi-polar disorder and sometimes schizophrenia.
How does ECT work?
An ECT machine passes an electrical current through electrodes (either bi-lateral or unilateral) attached to the scalp, thereby causing a generalized seizure. A single treatment lasts about 5 minutes. Many years ago, no anesthetic was used and injuries occurred. Today, the patient is given general anesthestic and administered a paralyzing drug to prevent injury. This drug causes respiratory muscles to stop working and a ventilator is used during the procedure to breathe for the patient. Then an electric shock is administered through the electrodes causing a seizure. It is possible for the heart to slow or stop at the point of shock and to speed up again during the seizure. During and after the procedure, vital signs are monitored, as are oxygen levels in the blood stream.
How does informed consent come into play?
The decision to give involuntary ECT is made no differently than with any other type of mental health treatment. A patient's consent is all that is needed when capacity to make such a decision is not questioned. When it is believed the individual lacks the capacity to make the decision a doctor may take the issue to court. In New Mexico, when a treatment guardian is in place, he/she will make the decision although the individual's preference must be considered.
Will one treatment cure the symptoms of the occurring disorder?
The number of treatments in a course of therapy varies. It is usually a last resort treatment. Often it is a temporary fix and the symptoms may reappear. The length of time the results last differ for different individuals.
Do all doctors and patients agree on safety and results of ECT?
Many consumers are reluctant to have ECT due to the possibility of short term or long term memory loss. Doctors, too, have their disagreements. Some doctors use ECT because they feel this treatment is all that is left to change the behavior and or symptoms of the patient. Some doctors believe it is a very effective form of treatment.
What is the legal status of ECT treatment decisions?
In New Mexico, ECT treatment decisions are made in the same manner and time frame as any other mental health treatment decision. There are no special provisions or limitations to its use. In the State of New York, where state hospitals use ECT in greater proportion than many other states, legislation is being discussed.
What can you do to be well prepared?
Be a part of local and national consumer groups and read the medical literature available. Prepare an Advanced Directive for your mental health treatment. There are a number of internet websites with information about ECT. You should also talk to your doctor.