E.C.T or Electro Convulsive Therapy is useful in a host of psychiatric illnesses including major depressive disorder, Schizophrenia, Mania, OCD, Catatonia, Suicidal ideation, NMS, etc.
E.C.T is a safe procedure and contrary to popular belief, it does not cause any temporary or permanent brain damage to the patient. In fact, it may be considered much safer than many of the available drugs.
E.C.T is considered one of the least harmful treatments for severely depressed pregnant women. Sometimes, a fundus examination (eye checkup) or a C.T. scan brain has to be done prior to E.C.T in patients whom we suspect a high intracranial tension. Before E.C.T, short-acting general anesthesia is given by the anesthesiologist along with muscle relaxant and Atropine.
The patient should not consume anything by mouth 6 hours prior to the procedure (nil by mouth). A consent form has to be signed by the patient or the relatives/caregivers. Before the procedure, the patient should empty his/her bowel and bladder, remove any dentures and contact lenses and loosen any tight clothing.
In our clinic, we give a twice-weekly course of E.C.T. but it depends on the severity of the symptoms. We need to give 5 to 12 E.C.T sessions, again, depending on the severity of symptoms and response to therapy.
Sometimes, some medications need to be withheld during an E.C.T course (e.g. Valproate or Lithium). We have a brief pulse E.C.T. machine which causes minimum cognitive effects (fewer side effects), than any other setups which use a sine wave machine. After the procedure, the patient wakes within one hour, and he can go home after 2-3 hours. He can consume water after 2 hours and semisolid food after 3 hours. If he has any headache or nausea, he will be given appropriate medication for that.
A mild forgetfulness of 2-3 hours duration, prior to the event of giving E.C.T. is normal. Therapeutic benefit is evident after 4th or 5th E.C.T session only. It is absolutely essential to continue medication during and after the E.C.T. procedure as long as advised for complete recovery.