Other Treatments

Other Treatments

Electroconvulsive Therapy

Electroconvulsive therapy (ECT is a non-drug treatment for bipolar disease and other mental disorders, such as severe depression. It is commonly called shock therapy. ECT has received bad press since it was introduced in the 1930s. But, over the years it has been refined, and is now considered a very safe treatment.

Research suggests ECT may be particularly beneficial for:

• Patients who need immediate stabilization of their condition and who cannot wait for medications to work
• Most patients with mania -- especially elderly patients with severe mania
• Patients who suffer suicidal thoughts and guilt during the depressive phase
• Pregnant patients
• Patients who cannot tolerate drug treatments
• Patients with certain types of heart problems
• Young patients

In a review of studies, about 80% of ECT-treated patients experienced improvement, and for some, it is the only treatment that works.

The Procedure. ECT is performed on an outpatient basis and does not require hospitalization. In general, the ECT procedure is performed as follows:

• A muscle relaxant and short-acting anesthetic are given to the patient.
• A small amount of electricity is sent to the brain, causing a generalized seizure that lasts for about 40 seconds.
• The response to ECT is usually very fast, and the patient often needs less medication afterward.

Side Effects. Side effects of ECT may include temporary confusion, memory lapses, headache, nausea, muscle soreness, and heart disturbances. Taking the drug naloxone immediately before ECT may help reduce its effects on concentration and some (but not all) forms of memory impairment. Concerns about permanent memory loss appear to be unfounded. One study that used brain scans before and after ECT found no evidence of cell damage. In another small study of teenagers who had undergone ECT for severe mood disorders, only 1 in 10 reported memory impairment 3.5 years after treatment.

Biologic Effects of ECT on Bipolar Disorder. The precise way that ECT benefits patients with bipolar disorder is not clear. ECT may help by: