Electroconvulsive therapy (ECT): what it is, when to do it and how it works

Electroconvulsive therapy, popularly known as electroshock therapy or just ECT, is a type of treatment that causes changes in the electrical activity of the brain, regulating the levels of the neurotransmitters serotonin, dopamine, norepinephrine and glutamate. By regulating these neurotransmitters, it is a therapy that can be used in some more severe cases of depression, schizophrenia and other psychological disorders.

ECT is a very efficient and safe method, since brain stimulation is performed with the patient under general anesthesia, and the seizures generated in the procedure are only perceived in the equipment, with no risk for the person.

Despite having good results, electroconvulsive therapy does not promote the cure of the disease, but it considerably reduces symptoms and should be performed periodically according to the recommendation of the psychiatrist.

When it is indicated

ECT is mainly indicated for the treatment of depression and other psychological disorders, such as schizophrenia, for example. This type of treatment is done when:

• The person has a suicidal tendency;
• Drug treatment is not effective or results in many side effects;
• The person has severe psychotic symptoms.

In addition, electroshock therapy can also be performed when treatment with medications is not recommended, which is especially the case for pregnant women, breastfeeding women or the elderly.

ECT can also be performed on people diagnosed with Parkinson's, epilepsy and mania, such as bipolarity, for example.

How it works

ECT is performed in a hospital environment, which can last up to 30 minutes and does not cause pain or discomfort to the patient. To perform the procedure, the person needs to be fasting for at least 7 hours, this is because general anesthesia is required, in addition to muscle relaxants and the application of cardiac, brain and blood pressure monitors.

Electroconvulsive therapy is performed under the supervision of the anesthetist and psychiatrist and consists of the application of an electrical stimulus, using two electrodes placed on the front of the head, capable of inducing the seizure, which is only seen on the encephalogram device. From the electrical stimulus, the levels of neurotransmitters in the body are regulated, making it possible to reduce the symptoms associated with psychotic and depressive disorders. Know what the encephalogram is.

After the procedure, the nursing team ensures that the patient is well, being able to drink coffee and go home. ECT is a fast, safe and effective therapeutic method, and periodic sessions should be performed according to the degree of the psychological disorder and the psychiatrist's recommendation, with 6 to 12 sessions being normally indicated. After each session, the psychiatrist performs the patient's evaluation to verify the treatment result.

As it was done in the past

In the past, electroconvulsive therapy was not only used to treat psychiatric patients, but also as a form of torture. This is because the procedure was not performed under general anesthesia and there was no administration of muscle relaxants, which resulted in contortions during the procedure and multiple fractures, due to muscle contraction, in addition to the loss of memory that often happened.

Over time, the method has been improved, so that it is currently considered a safe procedure, with a low risk of fracture and memory loss, and the seizure is perceived only in the equipment.

Possible complications

ECT is a safe technique, however, after the procedure, the patient may feel confused, have temporary loss of memory or feel unwell, which is usually the effect of anesthesia. In addition, there may be the appearance of mild symptoms, such as headache, nausea or muscle pain, which can be treated quickly with some medications capable of relieving the symptoms.

When not to do

Electroconvulsive therapy can be done on anyone, however people who have intracerebral injuries, suffered a heart attack or stroke, or have severe lung disease, will only be able to perform ECT after considering the risks of the procedure.

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