Hockenbury Discovering Psychology 5th txtbk

614 CHAPTER 14 Therapieselectroconvulsive therapy (ECT)A biomedical therapy used primarily in thetreatment of depression that involves electricallyinducing a brief brain seizure; alsocalled electroshock therapy.Electroconvulsive Therapy ECT is used as atreatment for major depression, especiallyin people who do not respond to antidepressantmedications. During an ECT treatment,the person is given a short-actinganesthetic and muscle relaxants. A mildbrain seizure, which lasts about a minute,is induced by a brief pulse of electricity.Although ECT can be an effective shorttermtreatment for people with major depression,the treatment effects tend to beshort-lived. About half of the people whoundergo ECT experience a relapse of thedepression symptoms within a few months(Kellner & others, 2006; Tew & others, 2007).Electroconvulsive TherapyAs we have just seen, millions of prescriptions are written for antidepressant medicationsin the United States every year. In contrast, a much smaller number of patientsreceive electroconvulsive therapy, or ECT, as a medical treatment for severedepression. Also known as electroshock therapy or shock therapy, electroconvulsivetherapy involves using a brief burst of electric current to induce a seizure in thebrain, much like an epileptic seizure. Although ECT is most commonly used to treatdepression, it is occasionally used to treat mania, schizophrenia, and other severemental disorders (Gazdag & others, 2009).ECT is a relatively simple and quick medical procedure, usually performed in ahospital. The patient lies on a table. Electrodes are placed on one or both of thepatient’s temples, and the patient is given a short-term, light anesthetic and musclerelaxingdrugs. To ensure adequate airflow, a breathing tube is sometimes placed inthe patient’s throat.While the patient is unconscious, a split-second burst of electricity induces aseizure. The seizure lasts for about a minute. Outwardly, the seizure typically producesmild muscle tremors. After the anesthesia wears off and the patient wakes up,confusion and disorientation may be present for a few hours. Some patients experiencea temporary or permanent memory loss for the events leading up to the treatment.To treat major depression, the patient typically receives two to three treatmentsper week for two to seven weeks, with less frequent follow-up treatments forseveral additional months (Fink, 2009).In the short term, ECT is a very effective treatment for severe depression: About80 percent of depressed patients improve (Glass, 2001; Rasmussen, 2009). ECTalso relieves the symptoms of depression very quickly, typically within days. Becauseof its rapid therapeutic effects, ECT can be a lifesaving procedure for extremely suicidalor severely depressed patients. Such patients may not survive for the severalweeks it takes for antidepressant drugs to alleviate symptoms.Typically, ECT is used only after other forms of treatment, including both psychotherapyand medication, have failed to help the patient, especially when depressionis severe. For some people, such as elderly individuals, ECT may be less dangerousthan antidepressant drugs. In general, the complication rate from ECT is very low.Nevertheless, inducing a brain seizure is not a matter to be taken lightly. ECThas potential dangers. Serious cognitive impairments can occur, such as extensiveamnesia and disturbances in language and verbal abilities. However, fears that ECTmight produce brain damage have not been confirmed by research (Eschweiler,2007; McDonald & others, 2009).Perhaps ECT’s biggest drawback is that its antidepressive effects can be shortlived.Relapses within four months are relatively common (Glass, 2001). About halfthe patients treated for major depression experience a relapsewithin six months. Today, patients are often treatedwith long-term antidepressant medication following ECT,which reduces the relapse rate (Sackeim & others, 2001).In cases of severe, recurrent depression, ECT may also beperiodically readministered to prevent the return of depressivesymptoms.At this point, you may be wondering why ECT is notin wider use. The reason is that ECT is the most controversialmedical treatment for psychological disorders(Shorter, 2009). Not everyone agrees that ECT is eithersafe or effective.Some have been quite outspoken against it, arguing thatits safety and effectiveness are not as great as its supportershave claimed (Andre, 2009). The controversy over ECT istied to its portrayal in popular media over time. The use ofECT declined drastically in the 1960s and 1970s when it