How many ect treatments are needed

Conclusion We found that the number of ECT sessions varied according to age and diagnosis. Acknowledgments Special thanks to staff at the Electroconvulsive Therapy Clinic, Ramathibodi Hospital, for supporting the data collection process. Author Contributions All authors contributed to the data analysis, drafting, and revising of the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure The authors report no conflicts of interest. References 1. Clinical Manual of Electroconvulsive Therapy. Arlington: American Psychiatric Publishing; American Psychiatric Association. American Psychiatric Association; Rapid response to electroconvulsive therapy: a case report and literature review. J ECT.

Contemporary use and practice of electroconvulsive therapy worldwide. Brain Behav. ECT use in unipolar and bipolar depression. ECT in bipolar and unipolar depression: differences in speed of response. Bipolar Disord. Ultra-brief pulse ECT in bipolar and unipolar depressive disorder: differences in speed of response. Volume of the human hippocampus and clinical response following electroconvulsive therapy.

Biol Psychiatry. Effectiveness of electroconvulsive therapy in patients with treatment resistant schizophrenia: a retrospective study. Psychiatry Res. Clinical characteristics of inpatients undergoing electroconvulsive therapy ECT in a university hospital, Thailand. Diagnostic and Statistical Manual of Mental Disorders. Washington: American Psychiatric Association; Clinical implications of brief psychiatric rating scale scores. Br J Psychiatry. The brief psychiatric rating scale: effect of scaling system on clinical response assessment.

J Clin Psychopharmacol. J Affect Disord. Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. Kongsakon R, Bhatanaprabhabhan D. Validity and reliability of the Young Mania rating scale: Thai version.

Although unusual, these cases underscore the potentially special efficacy of the first ECT session. Unfortunately, patients who have considerable symptom improvement after the first ECT session and who would be expected to do very well, never look as good as they did after that first treatment.

The reasons underlying such a trajectory of symptom persistence are not yet understood. What does the speed of response tell us about the mechanisms of action of ECT? Clearly, in certain patients, the neurobiological changes induced by ECT include almost immediate alterations in brain systems that regulate mood and affect. There is evidence to demonstrate that, overall, bipolar patients require fewer ECT sessions than unipolar patients.

Longer-term changes, such as synaptogenesis and neuronal regeneration, may also occur and contribute to the antidepressant and antipsychotic effects of ECT. The discovery of reliable biomarkers for ECT response would be a boon-both in furthering our understanding of mechanisms of action and in our ability to determine when an individual patient has had an adequate course of ECT. To date, the closest the field has come to such a biomarker is the DST.

When a patient is urgently ill eg, suicidal, catatonic, malnourished , this feature of the treatment may be lifesaving. Sometimes the rapid effectiveness of ECT may be used to help a patient and family with an important but nonmedically critical situation. The patient was quickly readied for her first ECT, which was given the day before the wedding. To that end, it is important to ensure that ECT is not relegated to the bottom of our treatment algorithms-the last resort option-while patients try sequential trials of antidepressant medications that may be less effective and slower- acting than ECT.

The efficiency of ECT, I: response rate in depressive episodes. Shapira B, Lerer B. Speed of response to bilateral ECT: an examination of possible predictors in two controlled trials. A study into predictors for the speed of response to electroconvulsive therapy. You can generally return to normal activities a few hours after the procedure. However, some people may be advised not to return to work, make important decisions, or drive until one to two weeks after the last ECT in a series, or for at least 24 hours after a single treatment during maintenance therapy.

Resuming activities depends on when memory loss and confusion are resolved. Many people begin to notice an improvement in their symptoms after about six treatments with electroconvulsive therapy. Full improvement may take longer, though ECT may not work for everyone.

Response to antidepressant medications, in comparison, can take several weeks or more. No one knows for certain how ECT helps treat severe depression and other mental illnesses. What is known, though, is that many chemical aspects of brain function are changed during and after seizure activity. These chemical changes may build upon one another, somehow reducing symptoms of severe depression or other mental illnesses.

That's why ECT is most effective in people who receive a full course of multiple treatments. Even after your symptoms improve, you'll still need ongoing depression treatment to prevent a recurrence. Ongoing treatment may be ECT with less frequency, but more often, it includes antidepressants or other medications, or psychological counseling psychotherapy.

Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Electroconvulsive therapy ECT is a procedure, done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure.

Request an Appointment at Mayo Clinic. There are many ways ECT may work. It may be related to changing the brain cell network communications that can be over-connected in depression. ECT appears to increase neurotransmitters, such as serotonin and dopamine.

ECT is used in people with treatment-resistant depression, mania, and psychosis from schizophrenia. Most people are receiving ECT for treatment-resistant depression, when antidepressant medication and psychotherapy have not worked. ECT is commonly done on an outpatient basis, but may be done as inpatient treatment when patients require hospitalization due to severe suicidality or inability to eat. The night before ECT, patients are asked not to eat or drink anything after midnight and until after their ECT treatment the following day is completed.

The morning of ECT, patients arrive to the waiting area and generally complete a clinical survey. During the procedure, the patient receives a brief-acting anesthetic, which puts the patient to sleep for approximately 7 minutes. Patients are not awake for the actual seizure as they are under anesthesia.