What is electroconvulsive therapy (ECT)?

Electroconvulsive therapy (ECT) is a medical treatment for serious mental health conditions. It is used to relieve your symptoms.

It involves sending a small electric current to your brain, causing you to have a seizure. You will first have an anaesthetic, so you will not feel the procedure or any pain.

What are the benefits of ECT?

ECT can be used to treat:

• severe depression
• psychosis
• repeating self-harming behaviours in people with autism spectrum disorder
• bipolar disorder
• schizophrenia

ECT is usually used when other treatments haven't worked. It might be considered after trying medicines, such as antidepressant medicines, or talking therapies, such as cognitive behaviour therapy (CBT).

ECT usually works faster than other treatments, making it a good option when you need quicker results.

What does ECT involve?

ECT is only available in approved hospitals or mental health facilities.

During each treatment, 2 doctors must be present. One doctor is a psychiatrist who specialises in ECT. The other is an anaesthetist who gives the anaesthetic. A nurse is also there to make sure you are well taken care of.

Before the ECT procedure, you will be given a general anaesthetic. This means you won't feel pain or be aware of what's happening during the procedure.

Electrodes are placed on one or both sides of your head. These are used to send a small electric current, which triggers a brief seizure. The seizure changes the chemicals in your brain to help improve your symptoms.

The procedure usually takes 20 to 30 minutes. A full treatment course involves 8 to 12 sessions. There are usually a few days between sessions. This depends on your mental health condition and how you respond to treatment.

After ECT, your treatment plan will be regularly reviewed. To help prevent relapse, you may need antidepressant or mood-stabilising medicines. Sometimes, you may need more ECT sessions together with medicines.

Informed consent

Before starting ECT, you must give informed consent. This means you understand the treatment, including the risks and benefits. You have the right to withdraw (stop) your consent at any time during the treatment.

Sometimes, you may be too unwell to give consent or have been ordered to have treatment without your consent based on the relevant state law. If this is the case, your psychiatrist will follow local and national laws to make sure you are safe.

How can I prepare myself for ECT?

You may need to have blood tests, an electrocardiogram (ECG) and an x-ray of your chest before you have ECT.

You will be asked not to eat or drink for up to 6 hours before each ECT session.

Ask your doctor if you should avoid taking any of your regular medicines before having ECT.

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How soon will I recover?

You will wake up a few minutes after the treatment is finished.

Read more about recovering from a general anaesthetic.

Like all treatments, ECT can have side effects. Short-term memory loss is the main side effect, but usually improves within 2 to 4 weeks after treatment. Other common side effects include:

• disorientation and confusion— you may feel this straight after ECT
• headaches
• nausea (feeling sick)
• sore muscles

What complications can happen?

ECT is considered a safe treatment with a very low risk of complications.

Sometimes, ECT can cause long-term or permanent memory loss. It may also affect your thinking and your ability to drive, especially in the first month after treatment. This should be considered when making major life decisions.

Occasionally, ECT can cause an abnormal heart rhythm. Your anaesthetist will check if you are at risk and monitor you during the procedure.

Rare complications include:

• fractures and dislocations
• injuries to your mouth or teeth
• risks of the anaesthetic
• heart attack or stroke

The risk of death from ECT is very low.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

Are there alternatives to ECT?

There are some alternatives to ECT. Your health team will help you consider these, based on your needs and how you respond to treatment.

Other treatments options may include:

• medicines — such as antidepressant medicines and mood stabilisers
• psychotherapy — such as cognitive behavioural therapy (CBT)
• repetitive transcranial magnetic stimulation (rTMS) — a treatment that uses magnetic fields to stimulate brain activity

What will happen if I decide not to have ECT or it is delayed?

If your doctor is prescribing ECT because you are very unwell and need a treatment that works quickly, you could be at risk of suicide if you don't have ECT, or if it is delayed.

Your doctor will only suggest you have ECT if they believe it is likely to help you. If you are concerned about having ECT, ask your doctor about other options and why they think ECT is a good choice for you.

Read the healthdirect page on suicide warning signs.

Resources and support

For more information about ECT, you can visit Black Dog Institute or Your Health in Mind.

If you need to talk to someone about your mental health, call Beyond Blue on 1300 22 4636.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Do you prefer to read in languages other than English?

The Multicultural Health Communication Service has fact sheets on electroconvulsive therapy in many languages.

Looking for information for Aboriginal and/or Torres Strait Islander people?

Black Dog Institute has support services for Aboriginal and/or Torres Strait Islander people.

13Yarn has crisis support for Aboriginal and/or Torres Strait Islander people. It's a confidential culturally safe space to yarn about your worries or concerns.

Looking for information for sexually and gender-diverse families?

HERE has information on suicide and situational distress and connects people of diverse genders and sexualities and their loved ones.