Instant Egghead Excerpts: Electroconvulsive Therapy

Electroconvulsive Therapy

THE BASICS

Eectroconvulsive therapy (ECT) sounds barbaric. (For a long time, it was colloquially called "shock therapy," after all.) Electrodes are attached to your head. You get muscle relaxants so you don't convulse and injure yourself and general anesthesia because otherwise what's about to happen would scare the living daylights out of you.

After you slip into unconsciousness, the electrodes are turned on, sending an electric current zapping into your skull. The current will cause neurons all over your brain to fire off their own electric signals and release all sorts of neurotransmitters. In response, you'll have a seizure. After the treatment, you'll wake up disoriented and confused and will likely have some short-term memory loss. Multiply that by the 6 to 12 treatments you'll need.

But here's the thing about ECT: It works. (Scientists still aren't sure why, but it does.) Somewhere in the neighborhood of two-thirds of patients who undergo the procedure find that their depression lifts afterward. And many of these patients are those who found absolutely no relief from other treatments. The technique has also been improved greatly in recent years. (It really used to be barbaric-now it just sounds that way.) ECT is still burdened by a not-quite-sterling reputation, but it remains a powerful intervention of last resort for patients suffering from severe depression.

ON THE FRONTIER

Though ECT has been used primarily to treat depression, it might also help the symptoms and daily functioning of schizophrenics. Though antipsychotic medications are still the first line of defense for schizophrenia, combining them with electroconvulsive shock therapy seems to be even more effective, particularly in spurring rapid improvement. Twenty percent of schizophrenics do not respond to medication, and adding a round (or several) of ECT could help them find relief.

COCKTAIL PARTY TIDBITS

In the early twentieth century, doctors became interested in the idea that seizures could help treat mental illness. They were exploring the idea of using chemicals to make the brain seize until Italian psychiatrist Ugo Cerletti had the idea that electric currents could do the same thing when he visited a slaughter-house where pigs were having their heads shocked�and surviving. That was all Cerletti needed to convince himself that a similar approach might be feasible on humans.
Before doctors thought to administer muscle relaxants, ECT used to cause patients to convulse so hard they would dislocate shoulders and break bones. That can't have helped anyone's depression.

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