Patient Education

Electroconvulsive Therapy (ECT)

About ECT

ECT uses a small amount of electrical current to alter the brain’s chemical responses. It is used for patients who do not respond to (or cannot tolerate) treatments, such as therapy sessions or medications for disorders, such as:

• Depression
• Mania
• Psychoses

ECT has proven to be a safe and effective treatment option and can bring about an:

• Increased activity level
• Improved mood
• Improved sleep patterns
• Increase in appetite

During ECT, you are not awake or aware of your surroundings. An anesthesiologist monitors you during the procedure and:

• Gives medications
• Provides oxygen via a special device (ambu bag)

ECT often includes a series of 6 to 12 treatments. These are done 3 times a week (Monday, Wednesday, Friday). Treatments may be given during a hospital stay or on an outpatient basis.

The number of treatments depends on your symptoms. Often it takes several treatments before ECT benefits are noted. This treatment still needs to be combined with your prescribed medicines and routine therapy sessions.

ECT Treatment

Getting Ready

Days before ECT treatment, you will meet with your psychiatrist and an anesthesiologist. They will explain ECT, its benefits and side effects. You will be given a consent form to sign. Certain tests may be needed, such as:

• EKG
• Blood and urine samples
• Chest X-ray

Outpatients need to check with their doctor for guidelines for taking needed medicines on the morning of their ECT treatments.

Night Before

Do not have anything to eat or drink after midnight the night before ECT.

Day of the Treatment

Inpatients

On the morning of ECT, nursing staff will prepare you for the ECT treatment. All jewelry, partial or full dentures, hearing aids, contact lenses, glasses and make-up must be removed. You will wear a hospital gown. Before you leave the unit you will need to empty your bladder. Then a unit staff person or a hospital transporter will take you on a stretcher to the ECT treatment area.

Outpatients

Do not have anything to eat or drink. As directed by your doctor, take any heart or blood pressure medicines (or other medicines) with small sips or water. It is helpful to wear loose comfortable clothing and remove and jewelry and nail polish. Be sure to:

• Have a responsible adult come with you to the hospital. You may not go home alone after ECT
• Bring your mouth guard and ambu bag to the hospital

Please come to the Same Day Surgery Unit, 5th floor Feinberg Pavilion, 251 East Huron Street. Parking is available for patients and visitors in the garage at 222 East Huron, across from the Feinberg and Galter Pavilions. For discounted rates, please bring your parking ticket with you. Tickets can be validated at the Customer Services Desks on the 1st and 2nd floor of the Feinberg and Galter Pavilions; 1st floor of Prentice (including the Prentice 24 hour desk near the Superior Street entrance).

When you first arrive, your registration is checked. If there are any delays, you may be asked to wait in the reception area. Staff will keep you updated during this time. The nurse takes you into the pre-ECT area and you are asked to change into a hospital gown. At this time dentures, hearing aids, contact lenses, and make-up must be removed.

The Treatment

After you arrive in the ECT area, an IV (into the vein) line is placed in your hand. It will be used for giving medicines and needed fluid. You will be attached to monitors to check your heart beat during the treatment. A cuff will be placed on your arm to check your blood pressure.

A specially trained team of doctors and nurses are present during the entire test:

• A Psychiatrist performs the ECT treatment
• The anesthesiologist monitors you during the treatment, gives medicines and assists your breathing as needed
• Nursing staff to assist and monitor your progress after ECT

Small pads will be placed on your head and upper body to check your brain waves. Medicine to make you sleep is injected into the IV. Your mouth guard is put in place. Once you are asleep, electric current passes from the ECT machine to your brain. This causes a seizure (with limited muscle movement) that lasts about 30 to 60 seconds. (IV medicine is used to control the body’s response to ECT.) You will have no pain or feeling during the treatment.

After ECT

After the treatment you will feel sleepy. The nursing staff will check on you often, and monitor your blood pressure and heart rate. As soon as you are alert and breathing well:

Inpatients will return to their room on a stretcher. You may resume your regular diet. Many patients often take a nap when they return to their room. The nurse will continue to check on you.

Outpatients will change clothes. Each patient must go home with a responsible adult. You may resume your regular diet. For the next 24 hours, do not:

• Make any important decisions
• Drive a car or any other vehicle or operate dangerous equipment

You will not remember the actual ECT treatment.

Common Side Effects:

• Headache
• Muscle aches
• Nausea
• Slight sore throat (if a breathing tube was in place during ECT)
• Medicine can be given to relieve these effects. Tell your nurse or doctor if any of these effects are noted.

In some cases, patients may have either:

• Short-term memory loss during the period of time of the ECT treatments (e.g., forgetting what you had for dinner, not remembering talking to someone earlier in the day). Your ability to remember will other return within a few weeks to a few months after the treatments are finished.
• Some patients describe “spotty” memory loss for events that occurred as far back as 6 months before starting ECT treatments. This memory loss can persist.

Be sure to tell your doctor and the nurse about any memory loss.

Maintenance ECT

To obtain the best outcome to improve your quality of life, your doctor may suggest weekly or monthly outpatient ECT treatment along with medicines and regular therapy sessions.

Health Information Resources

For more information, visit one of Northwestern Memorial Hospital’s Health Learning Centers. These state-of-the-art health libraries are located on the third floor of the Galter Pavilion and on the first floor of the Prentice Women’s Hospital. Health information professionals are available to help you find the information you need and provide you with personalized support at no charge. You may contact the Health Learning Centers by calling 312-926-LINK (5465) or by sending an e-mail to hlc@nmh.org.