Electroconvulsive Therapy and Other Brain Stimulation Therapies
For cases in which medication and/or psychotherapy does not help relieve symptoms of depression, electroconvulsive therapy (ECT) may be useful. ECT, formerly known as "shock therapy," once had a bad reputation. But in recent years, it has greatly improved and can provide relief for people with severe depression who have not been able to feel better with other treatments.
How ECT Works
Before ECT begins, a patient is put under brief anesthesia and given a muscle relaxant. He or she sleeps through the treatment and does not consciously feel the electrical impulses. Within an hour after the treatment session which takes only a few minutes, the patient is awake and alert.
A person typically will undergo ECT several times a week, and often will need to take an antidepressant or other medication along with the ECT treatments. Although some people will need only a few courses of ECT, others may need maintenance ECT--usually once a week at first, then gradually decreasing to monthly treatments. Ongoing ECT research is aimed at developing personalized maintenance ECT schedules.
Side Effects of ECT
ECT may cause some side effects, including confusion, disorientation and memory loss. Usually these side effects are short-term, but sometimes they can linger. Newer methods of administering the treatment have reduced the memory loss and other cognitive difficulties associated with ECT. A patient always provides informed consent before receiving ECT, ensuring that they understand the potential benefits and risks of the treatment.
Other Brain Stimulation Therapies
Other more recently introduced types of brain stimulation therapies used to treat severe depression include vagus nerve stimulation (VNS), and repetitive transcranial magnetic stimulation (rTMS). These methods are not yet commonly used, but research has suggested that they show promise.