Electroconvulsive Therapy: A Literature Review

Electroshock therapy is the process of electroshocking the brain of a human, this a process that takes multiple sessions (CBS News). ECT caused critical seizures. Doctors used this method to cure of reduce schizophrenia. Electroshock therapy was performed daily, it was known referred to as “The shock of the day” (D’Antonio). Doctors saw ECT as a easy and fast way to cure a patient.

Still today it is not known why ECT works but it seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental illnesses. It is also said that the shock literally shocks the person out of their illness as it is regarded as a punishment for the inappropriate behaviour. Another explanation is that the associated memory loss following shock allows the person to start afresh. They literally ‘forget’ they were suffering from a mental illness. Created in +1934 by Hungarian neuropsychiatrist Ladislas Meduna, [11]. However, ECT was not introduced in England until 1939 when Lothar Kalinowsky, observed the treatment administered in Italy and decided to use it in England due to its promising results. During this time high doses of electricity were administered without anaesthesia and muscle relaxations. This lead to memory loss, fractured bones and other serious side effects, which lead to, much of the stigma attached to ECT, because of these early treatments [12]. ECT is a treatment that is still used today, however much less brutally than in the 1930s.

However, there still remains controversy. There remains controversy because some experience more negative effects than they do positive effects. Negative results include side effects, relapse, and possible death. On the other hand, the positive result is an immediate anti-depressant effect despite the possible side effects and relapse. Some argue however, "There is no controversy about the indications for ECT and its efficacy in alleviating severe mood disorders, not about the safety of the procedure when properly done" (2). There are those who argue that ECT is brain-damaging or brain-disabling, but research has not been able to find tangible evidence on long-term brain changes when properly administered.

Electroshock therapy is most effective for severe depression. People who need ECT the most are the ones who do not respond well to other treatments or have suicidal thoughts. There are other treatments for depression besides electroshock therapy such as medication; however, there are people who medication does not help. There is a kind of checklist that the doctor goes by that shows him that the shock therapy is needed. The first thing the doctor assesses is if the patient is unable to tolerate the side effects of the medication. In addition, he looks at if they responded well to a previous round of ECT rather than medication. There also may be reasons that

Although more SZ patient improved with real ECT, which compared to placebo, when comparing to antipsychotics medication, the drugs are more beneficial. There was some limited evidence to suggest that ECT combined with medication resulted in greater improvement in mental state. The conclusion was that a combination of drugs and ECT could be useful if a rapid reduction of symptoms is required or when patients don’t respond well to drugs alone. (Tharyan and adams 2005)

ECT has become much safer than the dangerous past shown in One Flew Over the Cuckoo’s Nest. Electroconvulsive therapy has little resemblance to that depiction. ECT brings about fast results compared to some other medications and treatments. After the shock, there is immediate relief to the symptoms of many mental illnesses. The electric current only lasts for a few seconds and the seizure lasts for about a minute. Many medications take weeks to become effective and ECT is an ideal option for those people that need the relief right away. ECT has often worked when many other treatments have

(Nordenberg, 4-6). People with milder forms of depression may respond favorably to psychotherapy; however, it is common for people with moderate to sever depression to benefit from both the use of anti-depressants and psychotherapy. Lastly, electroconvulsive therapy (ECT) is used by people who suffer from severe depression or by people whose depression is life threatening or for those who cannot take anti-depressant medications. ECT is most effective where anti-depressants can't provide sufficient relief of symptoms. In order for ECT to be effective, several sessions are necessary, usually three sessions per week. (5). ("Depression: An Overview" 5-7).

I learned that often times, ECT is used along with a general anesthesia and a brief electrical current initiated to trigger a brief seizure. Likewise, I realized that ECT is the preferred treatment when other options are not as well tolerated. After becoming more familiar with the procedure, it seems as though ECT may be a more desirable option than pharmacological interventions as drug interventions may require more time to become effective. Sometimes when a patient's signs and symptoms are overwhelming, interfering with their daily life, time is of the essence and ECT provides a quicker relief for individuals with immediate risk. After several years and improvement technology, ECT has become much safer in the past, presenting minimal possible risks - memory loss, confusion, headache or muscle ache - to the

Electroconvulsive therapy, also known as ECT, is a medical procedure that is used in the treatment of mental illness. In ECT, a small electrical impulse is sent through the brain, resulting in an ephemeral seizure. Though the process is generally effective, modern science is unaware of the explanation behind ECT's success. Its history is filled with a large amount of stigma and the use of ECT as a therapy is still debated today. ECT has evolved to a point where its beneficial effects can be maximized and its adverse effects can be minimized through proper administration.

Much of the controversy surrounding this topic revolves around its effectiveness vs. the side effects, and the recent increase in ECT as a quick and easy solution, instead of long-term psychotherapy or hospitalization. Because of the concern about permanent memory loss and confusion related to ECT treatment, some researchers recommend that the treatment only be used as a last resort. It is also unclear whether or not ECT is effective. However, other studies indicate that the relapse rate is high, even for patients who take medication after ECT. Some researchers insist that no study proves that ECT is effective for more than four weeks.

(Geddes, 2003). As Vothknecht et al. show, relapse rates range – exceeding 50% (in 6 to 12 months after initial electroconvulsive treatment) up to 95% (2004). With the clearly high indications or relapse, one can understand as to why so many oppose the use of ECT.

The first argument for the use of ECT is the fact that majority of studies and modern literature show that this treatment is very successful in treating many psychological disorders. Evidence seems strongest for the efficacy in severely depressed patients, as well as manic patients (Reisner, 2003). When looking at those with major depression, the likelihood of substantial improvement ranges from 80-90% (Weiner & Krystal, 1994). In manic patients, Gabbard concludes that 80% of patients show “marked improvement” (2001, p.1272).

The hippocampus lies near the center of our brain. It's functions include storing our memories and maintaining a hormone called cortisol. During the time of physical and mental stress, our body releases immoderate amount of cortisol that can create chemical imbalance in the body and cause problem. During depression, long term exposure to increased cortisol level in dentate gyrus (a part of hippocampus) cause hippocampus to shrink as well slow down the production of our neurons. This can lead to memory

The results display that patients who had been withdrawn from cognitive therapy treatment were less likely to relapse (30.8%) than those who had been withdrawn from medications (76.2%). No significant difference was found between patients

The rationale for ECT is to provide relief from the signs and symptoms of mental illnesses such as severe depression,