18 April 2016
The truth about Electroconvulsive Therapy
It's often considered a treatment from yesteryear and can
be viewed as controversial, but what's the truth about
Electroconvulsive Therapy (ECT) and its role in modern mental
health care? Who better to tell us than one of the busiest ECT
teams in the country?
What is ECT and why is it used?
ECT is a psychiatric treatment, always given under general
anaesthetic, traditionally by doctors. It involves administering an
electric stimulus through the brain to trigger a seizure. ECT was
developed in Italy in the late 1930's by two psychiatrists
researching schizophrenia, although the treatment has no impact on
ECT is now used to treat people suffering from severe, disabling
and often life threatening depression.
The treatment process
John Leyden, a national ECT senior nurse and manager of
Wiltshire's ECT service, tells us a bit more about the
"All referrals come through community teams and Trust
consultants" says John. "The decision to undertake ECT needs to be
carefully considered. Treatment should only be prescribed for
specific criteria, including those suffering from mania, catatonia
or moderate to severe treatment resistive depression, often when a
person's illness has become severely debilitating or is life
threatening. Some patients are so ill they have stopped eating and
drinking and in these cases ECT can be lifesaving."
It is important to complete the treatment course (routinely 6-9
treatments) with improvement generally noted after the
3rd or 4th treatment. ECT carries the same
risk as other procedures carried out under general anaesthetic. The
risks of treatment are weighed up against the benefits and the risk
of not treating.
Patients and relatives are often anxious about the procedure, so
a big part of the ECT team's job is to minimise their distress and
anxiety. Once people equate feeling better with the treatment, they
become less anxious.
ECT has a 73% effectiveness rating and scores well considering
the nature of treatment resistive depression. Relapse can happen
and it is important that ECT ties in with other treatments to
Side effects from treatment include post treatment headache and
nausea, short term memory loss and disruption of autobiographical
memory. Considerable work has gone into research over the last few
years to improve equipment and minimise the side effects.
Innovators in the field
The Wiltshire ECT team (pictured) had an academic paper
published in the Journal of ECT in December 2015, reporting on a
successful pilot study of nurse administered ECT treatment. The
subject remains under discussion but following this, our Trust may
have the first ECT team worldwide to have nurse administered
The Wiltshire ECT team has been recorded as the most travelled
in the country and has achieved an excellent accreditation rating
for 3 years running. John has even been asked to sit on an expert
panel at the Old Vic in London to answer questions and discuss ECT
following a showing of Harold Pinter's play The Caretaker
which features a scene about the treatment.