The most effective treatment for depression, ECT can also be used to treat catatonia and other forms of mental illness, particularly when symptoms have not responded to other treatments. ECT can be given to hospitalized patients or on an outpatient basis.
Most people will need 6 to 12 treatments, which are initially given 2 to 3 times a week, but the exact number will be individualized based on the person's needs and response. Some people benefit from additional maintenance treatments to keep symptoms from returning.
Before beginning ECT, a person will be evaluated carefully to see if ECT is likely to be helpful and to fit the treatment approach to their medical and psychiatric needs. As part of this evaluation, the Stony Brook ECT Service team, led by Laura Fochtmann, MD, and Adeeb Yacoub, MD, will ask for information from the mental health professional who is currently providing treatment.
During each ECT treatment, an ECT nurse will prepare the patient for the treatment. Next, an anesthesiologist gives an anesthetic medication and a muscle relaxing medication. Once the patient is asleep, the psychiatrist gives a very brief electrical stimulation through electrodes placed on the patient’s head. This creates a short seizure, which produces the beneficial effects of ECT. As with any procedure that involves anesthesia, there is a very rare risk of breathing or heart problems. Consequently, the patient’s heart rate, blood pressure, and oxygenation are monitored closely throughout the treatment, which takes 5-10 minutes. Additional monitoring takes place for about an hour, until the patient is ready to leave the recovery area. Many people will experience confusion, problems with concentration, or temporary gaps in memory around the time of the treatment. These usually resolve within two weeks of stopping ECT, but less commonly, memory gaps can persist or affect memories that are further in the past. Other side effects include headache, nausea, or muscle aches, which are temporary and can be treated with medications. Our ECT team encourages patients and families to ask, at any point, if they have questions about side effects or other aspects of the ECT treatment.