Bipolar Disorder: Electroconvulsive Therapy

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Electroconvulsive Therapy (ECT) is sometimes used in the treatment of bipolar disorder.

ECT 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.

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.


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.


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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.

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 anaesthesia.

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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.

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

 

 

 

For more information, please read Electro-Convulsive Therapy (ECT) Information Booklet. Vancouver Hospital and Health Sciences Centre.


Developed by the Mood Disorders Association of British Columbia. For information on support for people with mood disorders and their families please visit our website www.mdabc.net. Funding for this fact sheet was made possible by the Provincial Health Services Authority.

 

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