What is electroconvulsive therapy (ECT)
Electroconvulsive therapy (ECT) is a procedure, done under general anaesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure. It is conducted in a safe and controlled environment.
ECT is among the most effective treatments available for depression and is generally suitable for patients with severe conditions, who are unresponsive to other forms of therapy. It is one of the fastest ways to relieve symptoms in severely depressed or suicidal patients.
It is thought to improve depression in 70 to 90 per cent of patients, with a response rate much higher than that of antidepressant drugs.*
Furthermore, eight out of 10 patients who receive electroconvulsive therapy (ECT) respond well to the treatment. People who have had the treatment often say it makes them “feel themselves” again.
Although ECT has been used since the 1940s and 1950s, it remains misunderstood by the general public. Many of the procedure’s risks and side effects are unrelated to the treatment. ECT, when applied in a controlled environment by highly trained, professional medical staff is safe to use and can be highly effective in the treatment of certain mental illnesses.
What can electroconvulsive therapy (ECT) treat?
ECT is generally used when those with severe depression are unresponsive to other forms of therapy. Or it might be used when patients pose a severe threat to themselves or others and it is too dangerous to wait until medications take effect.
It’s also very effective for patients who suffer from mania or a number of other mental illnesses.
Prior to ECT
Before commencing treatment, you will undergo an extensive assessment, which includes the following:
- Electrocardiogram (ECG)
- Blood test, depending on your current medication
- Body Mass Index (BMI)
- Chest x-ray if you have any respiratory problems or are over 65 years of age
24 hours before the treatment, you need to prevent taking Lithium Carbonate and Clozapine. On the night before the treatment, you need to avoid taking benzodiazepines and phenothiazine (Chlorpromazine), but you should take your antihypertensive medication by 6 am. You should also abstain from eating or drinking after midnight.
What happens during electroconvulsive therapy (ECT)?
On the day of your appointment, you should wear comfortable and loose clothing.
You will be required to have a carer or companion escort you to and from Nightingale Hospital on the day of your treatment. You will be expected to arrive at Nightingale by 8:00 am on the morning of your treatment.
At Nightingale, you will be required to complete a pre-ECT checklist and have your vital signs checked.
If you are cleared for treatment, you will be escorted to the Northwick Park Hospital in Harrow by a member of Nightingale Hospital for your first session.
There, the treatment will be carried out by a psychiatrist from the ECT clinic with the assistance of the ECT lead nurse.
- You will be laid on a comfortable bed and assisted by a nurse. You will be asked to remove your shoes, jewellery and any dentures/piercings you may have
- A general anaesthetic injection will be given to you by the anaesthetist with the assistance of the anaesthetic nurse.
- Once unconscious, you will be given a muscle relaxant to stop your body from convulsing during the treatment. A mouthguard will be placed in your mouth for your protection.
- Electrodes will be placed on your head (either unilaterally or bilaterally, depending on your ECT prescription).
- The ECT machine will produce a series of brief electrical pulses, creating a controlled seizure. This will last approximately 12 seconds each time. The entire treatment will last around 5 minutes.
- Once the treatment is finished, you will slowly become conscious again.
How will I feel after electroconvulsive therapy (ECT)?
You may feel slightly disorientated, confused, or forgetful. Following treatment, you will be taken into a recovery room where a recovery nurse will check your vital signs and orientations.
You may experience a slight headache as well as some aches and pains. This is entirely normal and will only last for a few minutes.
You are strongly advised not to drive or undertake any other activity which could risk your health for the next 24 hours.
How many treatment sessions might I have?
When beginning ECT, it is standard practice to be prescribed between 6 and 12 treatments to start
After every two treatments, your consultant psychiatrist will review your progress thoroughly before continuing.
Electroconvulsive therapy (ECT) at Nightingale Hospital London
Nightingale Hospital has a formal agreement with the Central and North West London NHS Foundation Trust (CNWL), for the delivery of ECT. This agreement provides Nightingale Hospital patients with access to treatment at Northwick Park Hospital, Harrow.
The cost of ECT treatment at Nightingale Hospital is inclusive of private transfer from Nightingale Hospital to Northwick Park Hospital, and a private nurse escort to and from each location.
All patients receiving ECT must be under the care of a Nightingale consultant psychiatrist. This treatment is available to both outpatients and inpatients.
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