Since the Italian neurologist Ugo Cerletti introduced electroconvulsive therapy as a treatment for various mental disorders in 1938, this technique has been the subject of powerful criticism, sometimes based on incorrect information.
Currently, and after more than 80 years of use, this therapeutic method continues to raise doubts regarding its effectiveness and safety. But what is this controversy due to? Is electroconvulsive therapy dangerous? First of all, let’s see what this type of intervention consists of.
Electroconvulsive therapy (ECT) is a procedure carried out under general anesthesia and consists of introduce small electrical currents through the brain to, in this way, intentionally trigger a brief seizure.
This technique consists of placing several electrodes on the patient’s forehead and a rubber tape around it through which the cables are connected, which in turn are connected to the machine that controls and executes the electrical mechanism.
During the procedure, the electrical current passes from the electrodes to the brain in just a few seconds. This is what causes the seizure, which usually lasts less than 1 minute. Because the patient is anesthetized and his muscles are relaxed, there is little or no sign that he is convulsing and his body is usually completely still.
The final objective of this therapeutic technique is cause changes in brain neurochemistry, so that some of the symptoms can be quickly reversed of the serious mental disorders and illnesses that it tries to alleviate.
The main indication for electroconvulsive therapy (ECT) is severe major depression that threatens life or significantly impairs the individual’s functioning. Due to its speed of action and effectiveness, it can be the treatment of choice in serious psychiatric disorders such as catatonia, depression, bipolar disorder and psychoses
This technique is considered the most effective and fastest acute treatment for treating major depression. According to randomized trials, remission occurs in 70-90% of patients who receive the therapy.
Another specific indication for ECT is unipolar psychotic depression, people with suicidal tendencies and malnutrition secondary to food refusal, severe catatonia, as well as people with episodes of recurrent depression and treated with this therapy after numerous medication failures.
It is considered that There are no absolute contraindications for ECT regardless of the type of population and its clinical situation, except for at-risk populations who must be cared for with closer supervision.
Main side effects
Like any therapeutic procedure, electroconvulsive therapy is not free of possible side effects These are the most common:
Headaches, nausea and muscle discomfort are usually mild and can be prevented or alleviated with medication. The most unpleasant side effect is usually memory loss although it is true that it reverses and disappears after a few weeks.
It must be clarified, however, that this type of side effects depends on the patient’s previous conditions, such as their age, their susceptibility to this type of treatment, the technique used or the frequency of administration.
There is evidence that electroconvulsive therapy It is one of the psychiatric treatments with the highest efficacy and safety rates for the treatment of some serious mental disorders.
Research concludes that the most common side effect is memory loss or amnesia. However, this therapy appears to have fewer side effects than some antidepressant and antipsychotic drugs in frail elderly patients.
The effects this technique may have on the developing brain are still unknown In pregnant and lactating women who are concerned about possible teratogenic sequelae (birth defects during the gestation of the fetus) and other side effects of the medication, it may also be effective, and they can be safely treated with this therapy.
A review of 300 cases of ECT during pregnancy found five cases of congenital anomalies (hypertelorism, clubfoot, optic atrophy, anencephaly, and lung cysts). The review concluded that these malformations were not a result of the therapy, and that there was no evidence of postnatal developmental effects.
Clinical research also supports the effectiveness and safety of electroconvulsive therapy as a therapeutic tool for the prevention of relapses in major depressive disorder, even in adolescents.
It therefore seems that, in view of the studies and research carried out, to the question of whether electroconvulsive therapy is dangerous we must answer with an unequivocal no, at least until the contrary is proven.
Efficacy in intervention on disorders
Research carried out indicates that electroconvulsive therapy (ECT) is effective in the short term for the treatment of depression, and is probably more effective than drug therapy bilateral ECT (with electrodes on both sides of the head) being moderately more effective than unilateral ECT.
Studies further conclude that high doses of ECT appear to be more effective than low doses in the treatment of serious mental illnesses such as depression and bipolar disorder. In addition, ECT is also shown to be effective in severe bipolar depression.
ECT would also be indicated in children and adolescents with severe and persistent major depression, with symptoms that are life-threatening or do not respond to other treatments. However, in this type of younger population, ECT should be used exceptionally and always carried out by a qualified professional.
All in all, ECT is a therapy reserved solely and mainly for patients with severe and persistent symptoms, especially when they have not responded to other types of treatment or when there is a real serious threat to their life.
