WHAT IS ELECTROCONVULSIVE THERAPY (ECT)?
Electroconvulsive Therapy (ECT) stimulates the brain with short, electrical stimuli that cause slight convulsions and help relieve symptoms of depression. Treatments are offered at Claro Clinic, a licensed ECT-facility in Cape Town.
- It is a brief medical procedure
- Administering short electric bursts to the brain, by use of external electrode pads to the brain.
- The procedure is done under short-acting, general anaesthesia lasting a few minutes.
- These bursts of electrical stimuli create a seizure, which assists in the opening of neuron pathways.
- It is a safe and pain-free procedure.
TREATMENT PLAN AND INDICATIONS
- ECT’s can be done as an in- or out-patient procedure.
- ECT treatments are usually grouped in 6 to 12 sessions, subject to your Psychiatrist’s evaluation.
- These treatments are typically given three times a week for 2 to 4 weeks.
- ECT is indicated for (but not limited to):
- Major depression with or without psychosis
- Treatment-resistant depression
- Bipolar disorder
- Maintenance ECT
- Catatonic states
IMPORTANT THINGS TO KNOW ABOUT THE PROCEDURE
- You will be monitored closely by an Anaesthesiologist, the Psychiatrist and trained professional nursing staff.
- Pre-assessment of your vitals considered high risk can lead to a cancellation of the procedure. The decision will be made for your own safety.
- The idea of this procedure is for the brain to reset itself because of the seizure, clearing the neuropathways and lifting the common symptoms of depression.
- The ECT will show a print-out of the seizure starting and levelling off, indicating the seizure’s completion.
- You are unconscious during the procedure.
- You will not feel a thing during this process.
BEFORE THE PROCEDURE
When an ECT is indicated for a patient, the following must take place:
- The Psychiatrist must explain the procedure, discuss all possible side-effects and acquire your written consent.
- You must be screened by the Anaesthesiologist to ensure that medically, it will be a safe procedure for you to undergo.
- Nursing staff will complete a questionnaire with you to acquire all the information
- Nursing staff will check your vitals before the procedure to ensure your current medical stability.
- You can wear comfortable, loose clothes, to facilitate easier attachment of the equipment.
- You will be asked to lock away all valuable objects, remove all jewellery and take out dentures, if applicable.
- You must be positively identified.
- You will proceed to the waiting area, from which nursing staff will call you for the procedure.
DURING THE PROCEDURE
- When you are comfortable on the bed in the procedure room, the Anaesthesiologist will find a vein in your hand or forearm to insert a cannula (tube).
- The Anaesthesiologist will administer the following:
- Short-acting general anaesthesia, you will be unconscious during the procedure.
- A muscle relaxant to prevent the body from convulsing during the procedure.
- Any other medications required for pain or nausea.
- To monitor all actions of the ECT, electrodes will be applied to your:
- Head (to monitor the induced seizure)
- Chest (to monitor your heart)
- Foot (to monitor movement)
- To block the muscle relaxant, a tourniquet will be placed around the leg of the foot that is connected to the electrodes (to monitor the reaction of the body.)
- Electrodes can be placed unilaterally, to affect one side of the brain, or bilaterally, to affect both sides.
- A mouth guard will be placed in your mouth to prevent you from accidentally biting your tongue.
- The electric impulses are administered by an ECT machine regulated by the Psychiatrist as required.
- The whole procedure will generally not last more than 10 minutes.
AFTER THE PROCEDURE
- A few minutes later, the anaesthesia and muscle relaxant effects will begin to wear off. Nursing staff will take you to the recovery room for further management.
- Observations: To ensure a successful recovery, your blood pressure, pulse and oxygen levels in the blood will be monitored.
- To prevent any infections, the cannula used for vein access is removed.
- You will be requested to perform specific actions to ensure that you are awake and alert (i.e., coughing or opening your eyes.)
- When there is evidence that you have recovered well from the anaesthesia (usually 15minutes), you will be escorted by wheelchair back to your bed or family.
As with medication, ECT’s do have some side-effects:
- Impairment in memory functioning, or memory loss. It usually affects short-term memory, but mostly this memory is recovered.
- You might experience muscle pain due to tense muscles.
- Nausea can be felt by some patients due to the anaesthesia.
- Headaches are prevalent after an ECT but are usually managed by mild analgesics like Panado.
- The procedure is very safe and the side-effects are mostly reversible or manageable.
RECOMMENDED HOME CARE
When arriving home with your loved one that has received ECT treatment:
- Please, provide them with something to eat as they have been fasting since the previous evening.
- Give mild analgesics, like Panado for any pain.
- Treat any nausea as usual (light meal or no food) until nausea settles.
- Memory loss is expected. Please, reassure your loved one and do not be alarmed (memory mostly returns several weeks after the last procedure.)
- Let your loved one guide their own recovery for the day and rest as much as needed.
- If you have any queries regarding post-ECT care, please contact Claro Clinic and speak to a Registered Nurse.
Download: ECT Brochure Life Path Health