Electroconvulsive Therapy (ECT)

brain neuromodulation by electroconvulsive therapy ect

What is electroconvulsive therapy (ECT)?

Electroconvulsive therapy (ECT) is a safe and effective treatment for some forms of mental illness. Resulting in a positive therapeutic change to brain function, ECT utilizes a mild electric current to stimulate a brief seizure in a highly controlled setting. Though research is still ongoing to understand the specific mechanism of action for ECT, psychiatrists can use this safe method for efficient and effective treatment.

Inpatient and outpatient ECT is available at NewYork-Presbyterian Westchester Behavioral Health and NewYork-Presbyterian/Weill Cornell Medical Center. To learn more about ECT services, please call Weill Cornell Medicine's ECT experts at 914.997.4323.

What are the benefits of ECT?

ECT can quickly treat several psychiatric conditions, especially when patients experience severe symptoms or are unresponsive to trials of multiple medications. ECT also typically works faster than psychiatric medications.

80% of patients with treatment-resistant depression whose symptoms have not responded to trials of two or three different medications experience symptom relief with ECT. These results are similar for patients with treatment-resistant mania, catatonia or schizophrenia.

What are the side effects of ECT?

As with many medical procedures and treatments, patients undergoing ECT may experience some side effects following the procedure.

Immediately after treatment, patients may experience confusion that will resolve within several minutes to hours. Some patients may experience headache, nausea, jaw pain or muscle aches, for which we recommend treating with over-the-counter medications.

Occasionally, patients may have trouble remembering events from the days and weeks before the treatment or events that occur during the acute phase of the treatment. These symptoms often resolve within a few months following treatment.

Are there any risks from undergoing ECT?

Like any medical treatment, ECT can have some risk. Since ECT is performed under general anesthesia, patients may carry the risk of increased heart rate or blood pressure, which in rare cases can lead to heart problems. When determining if ECT is the right treatment method for a patient, a physician will evaluate the patient's health for any heart or blood pressure risk.

Our ultimate goal is patient wellbeing and safety. Our providers strive to reduce the risks of ECT as much as possible while understanding that the risks of severe, untreated depression are often greater than the risk of ECT.

What patients would benefit from ECT?

ECT is most useful for patients suffering from conditions such as severe depression, severe mania, catatonia and schizophrenia. ECT is particularly useful when other treatment methods, such as medications or psychotherapy, are deemed to be ineffective or result in intolerable side effects.

What should patients expect during ECT treatments?

Our doctors will explain how to prepare for treatment to each patient, including guidelines on whether to take current medications the day prior to or in the morning before treatment. Patients should not eat or drink anything after midnight on the day of the procedure except small sips of water with any medications necessary to be taken before the ECT procedure.

On the treatment day, patients should wear loose-fitting, comfortable clothing. Once in the procedure room, the treatment team will introduce themselves and answer questions. The team includes a psychiatrist, an ECT nurse and an anesthesiologist.

Once the patient is ready to begin, they can expect:

An intravenous (IV) line specialist (nurse or doctor) will place an IV into the arm or hand.
The care team will place monitors on the head, chest, arms and legs.
Medications will be administered through the IV to help the patient fall asleep.
When confirmed to be asleep, medications will be administered to relax the patient's muscles.
A psychiatrist will administer a mild electric current to cause a brief seizure.

Patients are asleep for the procedure for about 5 minutes total. After the treatment, the patient will slowly wake up and be moved to the recovery area.

The entire process from check-in through recovery lasts about 75 minutes.

How many times does a patient need ECT?

We generally treat patients until their symptoms remit.

We treat 2-3 times a week during the acute phase of treatments. Most patients who are treated with ECT for depression receive 8-10 treatments. However, everyone is different, and our ECT team will provide you with a personalized treatment plan during your course of ECT.

Patients with illnesses other than depression may need more or fewer treatments, and each individual's treatment plan is tailored to their symptoms.

We may recommend that patients return for maintenance ECT periodically.

What happens if patients experience side effects?

The ECT team will carefully monitor for side effects. In order to prevent medical side effects, we ask patients to their primary care provider prior to starting ECT. During the course of treatment, we will monitor for side effects by asking questions, reviewing vital signs and administering tests. Sometimes, we can modify the treatment to alleviate side effects.

Is ECT covered by insurance?

ECT is usually covered by insurance. We have a program liaison to assist in determining if the procedure is covered by the patient's insurance.

What happens after ECT? Do patients continue their medication regimen?

We work carefully with an outpatient psychiatrist during and after treatment. Some patients will be able to take fewer medications following ECT. As some medications prolong the good effects of ECT, we may recommend for the psychiatrist to change or add to the patient's medication regimen.

Some patients require or request maintenance ECT, or a set of treatments that occur on a reduced schedule to keep the good effects of ECT lasting as long as possible. The ECT team continuously discusses the treatment plan even as symptoms improve.