Electroconvulsive therapy (ECT)

5-minute read

Key facts

Electroconvulsive therapy (ECT) is used to treat serious mental health conditions.
A general anaesthetic is given before ECT so that you don’t feel any pain.
ECT is considered a safe and effective treatment for severe depression.
ECT is useful because it works more quickly than other treatments.
ECT can only be given after you give informed consent.

What is electroconvulsive therapy?

Electroconvulsive therapy (ECT) is a medical procedure used to treat serious mental health conditions. ECT is considered a safe and effective treatment for severe depression.

ECT involves delivery of a small electric current to the brain while you are under anaesthetic.

ECT can only be given after you provide informed consent.

Informed consent

Before ECT can be used, you must give informed consent to show that you understand the treatment. This includes the risks and benefits. If you are unable to give consent because of poor mental health, there are rules your psychiatrist must follow.

A person who gives consent can withdraw it at any time during treatment.

When is ECT used?

ECT can be used to treat:

severe depression
other psychiatric disorders such as bipolar disorder and schizophrenia

ECT may be considered for the treatment of depression if other treatments have not worked. This includes antidepressant medicines and talking therapies such as cognitive behaviour therapy (CBT).

ECT is useful because it works more quickly than other treatments.

How is ECT given?

ECT is given by a psychiatrist and an anaesthetist. A general anaesthetic is given before the ECT procedure. The general anaesthetic means you will not feel pain or be aware during the procedure.

For ECT, electrodes are placed on one (unilateral) or both (bilateral) sides of your scalp. These are used to deliver a small electric current, which triggers a brief seizure. The seizure will last 20 to 60 seconds. The seizure changes the chemistry in your brain to help improve your symptoms.

You usually wake up 5 to 10 minutes after the procedure.

Between 8 and 12 sessions of ECT are given in a treatment course. There are usually a few days between sessions. This depends on the nature of the illness and how you respond to treatment.

What are the side effects of ECT?

You may feel disorientated and confused straight after ECT. Other common side effects are headaches and nausea (feeling sick).

The main side effect of ECT is short-term memory loss. This usually improves once you finish your ECT treatment. You should be fully recovered in 2 to 4 weeks.

In some people, ECT can cause long-term or permanent memory loss. This is very rare.

This should be considered when making major life decisions. Your ability to drive may also be affected, mainly in the first month after ECT.

Following successful ECT treatment, antidepressant or mood-stabilising medicines are usually needed for 1 to 2 years. The medicines may need to be combined with more ECT.

Repetitive transcranial magnetic stimulation (rTMS)

Repetitive transcranial magnetic stimulation (rTMS) is a treatment using a coil that creates a magnetic field. This coil is held next to your head to stimulate a small area on the surface of the brain. A session takes 10 to 30 minutes.

rTMS can be used to treat depression. It may be offered if you have not responded to antidepressant medicines.