Bipolar Disorder: Electroconvulsive Therapy

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Author: Mood Disorders Association of BC

 

ECT (electroconvulsive therapy) was first developed in the 1930s and is most commonly used to treat people with severe depression who do not respond to medications. ECT is also used to stabilize bipolar illness during extreme episodes of mania or depression.

For a growing number of patients, ECT can be a more powerful and longer lasting treatment. ECT may be recommended when a person is at risk for harming themselves (suicidal).

ECT has also been used when medications have not been effective in controlling symptoms or when a person cannot tolerate the side effects of the medication. ECT has also been used in situations where medical conditions, including pregnancy, make the use of medications too risky. ECT may also be recommended for elderly people who are on multiple medications and cannot take additional medications.

  • For certain people, ECT may be the safest form of treatment. It can work faster than medications to relieve symptoms.

ECT is a medical procedure that involves sending a carefully controlled electrical impulse through the brain. Medication is first given to relax the muscles and the patient is put to sleep so they are not conscious during the procedure. A small electrical current is delivered through electrodes that are placed on the side of the patient’s head. This electrical charge lasts from 1 to 4 seconds and causes a seizure that lasts about 30 to 60 seconds.

  • Modern ECT is a safe and effective way to treat bipolar disorder. Like all medical treatments, it is important to discuss this form of treatment with your doctor to see whether it is the right treatment for you.

Throughout the procedure, the medical staff monitors heart rate’ blood pressure, and brain waves to make sure that everything is okay.

Improvement generally occurs over several treatments. Some changes may be also immediate after the first treatment. Although the number of treatment depends on the individual, the average number is 6 to 12. In some cases, monthly treatments may also be advised.

Other treatments such as medications and therapy may also be recommended as a follow-up.

  • You should always report any side effects to your doctor so that they can work on ways to reduce them.

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How does it work?

Although the precise nature of how ECT works is not known, current theories suggest that it causes changes in the brain’s chemistry (as do medications).

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Risks and side effects

Like many other medical procedures, ECT does have risks and potential side effects. There is a risk is that the seizure can set off a manic episode. Doctors have strategies to deal with this such as treating with medication.

  • As with any medical treatment, the risks must be balanced against the benefits. In doing so, it is important to remember that ECT is often a treatment for patients in great need or those who haven't responded to other treatments or who may be suicidal.

There can be some initial short-term memory loss and confusion, which usually disappears within a few hours. Sometimes people might forget events that occurred around the time of the ECT treatment. Some people also experience longer-term memory loss.

Other side effects include muscle aches, jaw pain and headaches which usually disappear after a few hours and are often alleviated by taking plain Tylenol. Other risks of ECT are those associated with the use of brief general anesthesia.

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Effectiveness

ECT has been shown to produce substantial improvement in people who have not responded well to other treatments. For example, between 50 – 70% of people who do not respond to medications will respond well to ECT.

  • Studies have found no intellectual or memory differences between people who received ECT and those who did not.

In summary, ECT is one of several treatments that can help to improve symptoms in people with severe mental illness.

 

 
About the author

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The Mood Disorders Association of BC is a member of the BC Partners for Mental Health and Addictions Information. The organization is dedicated to providing support, education, and hope for recovery for those living with a mood disorder or other mental illness. For more, visit www.mdabc.net or call 1-604-873-0103.

 
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