Why it's done
By Mayo Clinic staffElectroconvulsive therapy (ECT) can provide rapid, significant improvements in severe symptoms of a number of mental health conditions. It may be an effective treatment in someone who is suicidal, for instance, or end an episode of severe mania. ECT is used to treat:
- Severe depression, particularly when accompanied by detachment from reality (psychosis), a desire to commit suicide or refusal to eat.
- Treatment-resistant depression, a severe depression that doesn't improve with medications or other treatments.
- Severe mania, a state of intense euphoria, agitation or hyperactivity that occurs as part of bipolar disorder. Other signs of mania include impaired decision making, impulsive or risky behavior, substance abuse, and psychosis.
- Catatonia, characterized by lack of movement, fast or strange movements, lack of speech, and other symptoms. It's associated with schizophrenia and some other psychiatric disorders. In some cases, catatonia is caused by a medical illness.
- Agitation and aggression in people with dementia, which can be difficult to treat and negatively affect quality of life.
ECT may be a good treatment option when medications aren't tolerated or other forms of therapy haven't worked. In some cases ECT is used:
- During pregnancy, when medications can't be taken because they might harm the developing fetus
- In older adults who can't tolerate drug side effects
- In people who prefer ECT treatments over taking medications
- When ECT has been successful in the past
- Kellner C. Overview of electroconvulsive therapy (ECT) for adults. http://www.uptodate.com/index. Accessed Sept. 17, 2012.
- Kellner C. Indications for electroconvulsive therapy (ECT) in unipolar depression and its efficacy. http://www.uptodate.com/index. Accessed Sept. 17, 2012.
- Payne N, et al. Electroconvulsive therapy: Part I. A perspective on the evolution and current practice of ECT. Journal of Psychiatric Practice. 2009;15:346.
- Fact sheet: Electroconvulsive therapy (ECT). Mental Health America. http://www.nmha.org/go/information/get-info/treatment/electroconvulsive-therapy-ect. Accessed Sept. 17, 2012.
- Sadock BJ, et al. Kaplan & Sadock's Comprehensive Textbook of Psychiatry. 9th ed. Philadelphia, Pa.: Wolters Kluwer Health Lippincott Williams & Wilkins; 2009. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=booktext&D=books2&AN=01412563/9th_Edition/5&XPATH=/OVIDBOOK%5b1%5d/METADATA%5b1%5d/TBY%5b1%5d/EDITORS%5b1%5d. Accessed Sept. 18, 2012.
- Brain stimulation therapies. National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/brain-stimulation-therapies/brain-stimulation-therapies.shtml. Accessed Sept. 18, 2012.
- Kellner C. Technique for performing electroconvulsive therapy (ECT) in adults. http://www.uptodate.com/index. Accessed Sept. 17, 2012.
- Depression. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/depression/complete-index.shtml. Accessed Sept. 19, 2012.
- Kung S (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 30, 2012.
- Ujkaj M, et al. Safety and efficacy of electroconvulsive therapy for the treatment of agitation and aggression in patients with dementia. American Journal of Geriatric Psychiatry. 2012;20:61.


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