Electroconvulsive Therapy in Addiction: Meaning, Steps, Use Cases, Effectiveness

Electroconvulsive Therapy (ECT) is becoming popular as a non-medication option for addiction-related mental problems. Despite controversies surrounding memory loss concerns, this FDA-approved therapy, administered by trained professionals, serves as a last resort, providing fast-acting relief with a response rate exceeding 70%. 

However, ECT is often used as a last-resort option after other treatments prove ineffective for serious health conditions like depression, schizophrenia, bipolar disorder, etc.

What is Electroconvulsive Therapy (ECT)?

Electroconvulsive Therapy (ECT) is a medical procedure that involves passing a mild electric current through the brain, intentionally triggering a brief seizure. This procedure is done under general anesthesia and is used to treat severe mental health conditions, including depression, schizophrenia, and bipolar disorder. ECT is often used when other treatments are unsuccessful and when the full course of treatment is completed.

ECT stimulates a brief pulse (0.5 to 2 milliseconds) or ultra-brief pulse (less than 0.5 milliseconds). The procedure causes a seizure within the brain, which lasts for approximately a minute]. ECT often works when other treatments are unsuccessful and when the full course of treatment is completed, but it is not effective for everyone.

What are the steps in Electroconvulsive Therapy?

The steps in the ECT procedure are as follows:

  1. Thorough psychiatric and medical assessment, including laboratory blood tests and an electrocardiogram (ECG), to ensure the patient is healthy enough for the procedure.
  2. Obtaining express written consent from the patient (or a legal court or guardian in certain cases).
  3. Preparing the patient for the procedure by administering a muscle relaxant and general anesthesia.
  4. Attaching electrodes to the patient's skull in precise locations.
  5. Delivering electrical stimulation to the brain in short pulses causes a seizure that lasts for about one minute.
  6. Monitoring the patient's recovery from anesthesia, which typically takes five to 10 minutes, and ensuring they are fully alert within an hour.

ECT is usually considered when other treatment options, such as psychotherapy or medication, have not been effective.

When Is Electroconvulsive Therapy Shown to Be Effective?

Electroconvulsive Therapy (ECT) is notably effective for severe mental health conditions, particularly in individuals with uncomplicated, severe major depression. Clinical evidence suggests that ECT produces substantial improvement in approximately 80% of patients with this condition.

  • Severe Depression: ECT can provide rapid and significant improvements in individuals with severe symptoms of depression. ECT can also be used for Schizoaffective disorder.
  • Bipolar Depression: ECT has demonstrated high response rates in the treatment of bipolar depression, with age being a significant prognostic factor.
  • Catatonia: ECT is effective in managing catatonic symptoms and other mental health disorders with catatonic features.
  • Treatment-Resistant Conditions: ECT is considered when other treatments have not been successful, making it a valuable option in cases of treatment-resistant mental health conditions.
  • Neuroplastic Changes: ECT has been shown to alter the levels of various biochemical mediators and induce neuroplastic changes, contributing to its efficacy in certain cases.
  • Medicine not working: ECT is considered when traditional treatments have not yielded positive results. ECT is also considered when the patient does not desire to use medications.
  • Need for Fast-Acting Treatment: ECT provides a rapid and fast-acting treatment option especially for those at immediate risk of suicide due to a mental health condition.

What is the Success Rate of Electroconvulsive Therapy?

When administered to suitable candidates Electroconvulsive Therapy (ECT) boasts a success rate of approximately 80-85%, outperforming medications that typically have a success rate of 50-60%. This makes it a highly effective option for individuals dealing with severe depression.

This therapy stands out as the most efficacious treatment for symptom remission of major depressive disorder, surpassing other available treatments. In terms of response rates, ECT proves highly beneficial for severe depression, with rates exceeding 70%, positioning it as the most effective antidepressant treatment available.

Why Does ECT Continue to Be Controversial Despite Its Effectiveness?

Electroconvulsive Therapy (ECT) remains a subject of controversy despite its effectiveness, primarily due to concerns surrounding memory loss, particularly events near the time of treatment. This controversy persists because ECT's efficacy varies among individuals, not all patients respond to conventional ECT monotherapy, and there are ongoing debates about its effectiveness, with critics highlighting potential substantial costs.

In a 2005 paper published in the International Journal of Environmental Research and Public Health by CA Galletly, electroconvulsive therapy (ECT) is highlighted as a controversial treatment despite its proven efficacy and safety. This scrutiny persists, indicating ongoing debates surrounding the use of ECT. 

Moreover, a 2009 paper by A Kavanagh on PubMed highlights the enduring stigma and controversy associated with ECT despite being in use for 70 years, emphasizing the need for ongoing scrutiny and discussion surrounding its application.

The controversy is fueled by research data indicating that memory loss is a significant concern, leading to discussions about its association with administration methods like bilateral vs. unilateral procedures. This unique information highlights the polarizing nature of ECT, as it remains a controversial therapy, unpopular in some countries but still in use in others.

Stats reveal that memory loss is a significant concern in the ongoing controversy surrounding ECT, prompting discussions about its association with administration methods, such as bilateral or unilateral approaches.

User experiences contribute to the controversy, with professional disagreements among healthcare professionals. Some endorse the helpfulness of ECT, while others believe it should not be used at all. Additionally, memory loss, whether short-term or long-term, is a concerning side effect for patients and families, adding to the controversial nature of ECT.

The lack of clear evidence regarding ECT's effectiveness and its impact on the brain contributes to ongoing debates, with critics expressing concerns about potential brain damage. Stigmatization and negative portrayals in media, along with a history marked by abusive practices, further contribute to ECT's controversial status. Gender concerns have also been raised, as the majority of ECT patients are women, impacting perceptions of gender equity and women's mental health.

What percentage of patients improve with ECT?

Research indicates that 64% to 87% of patients with severe Major Depressive Disorder (MDD) respond to ECT, with response rates as high as 95%. Another study suggests that a 30% improvement after six ECT sessions is a good predictor of remission in depressed in‐patients. 

Additionally, the Royal College of Psychiatrists notes that in 2018-2019, 68% of people treated with ECT reported significant improvement in their symptoms.

What Are the Odds of Relapse After ECT?

According to a study published in 2009 in the International Journal of Environmental Research and Public Health by Dr. G Rehor, the high relapse rate within 6 months after successful electroconvulsive therapy (ECT) poses a significant challenge for patients and psychiatrists.

A 2013 paper by A Jelovac found a 6-month relapse rate of 37.2% in patients treated with continuation ECT. Another meta-analysis revealed that, despite continuation pharmacotherapy, 51% of patients experienced relapse within 12 months post-successful ECT, with a majority relapsing within the initial 6 months.

Understanding and managing these relapse probabilities are crucial aspects of post-ECT care.

Why Is ECT a Last Resort?

Electroconvulsive Therapy (ECT) is often considered a last resort treatment option for severe mental health conditions, such as depression, schizophrenia, and bipolar disorder. This is because ECT involves sending an electric current to the brain, which causes a brief seizure within the brain. ECT can cause side effects, such as memory loss, which can be short-term or long-term.

The potential for side effects and the invasive nature of the treatment make it a last-resort option for many patients and healthcare professionals.

The perception of ECT as a last resort aligns with the stigma stemming from historical practices involving high doses of electricity administered without anesthesia, leading to memory loss and severe side effects.

While traditionally viewed as a last resort, ECT’s role is expanding, challenging misconceptions, and offering hope to a broader range of patients. It’s crucial to reassess its perception in light of evolving research and consider it as a valuable option in comprehensive mental health care.

Is ECT Dangerous?

ECT is generally considered safe when administered by trained professionals in appropriate medical settings. However, like any medical intervention, ECT carries risks, commonly associated with temporary memory loss and difficulty learning. Some patients may struggle to recall events preceding the treatment, with memory issues typically improving within a couple of months.

The decision to undergo ECT should be made after careful consideration of individual health factors and in consultation with a qualified healthcare provider. It is important to note that ECT is approved by the U.S. Food and Drug Administration (FDA) and is highly effective, particularly in cases where other forms of therapy have not been successful.

How Long Does ECT Memory Loss Last?

ECT can cause retrograde amnesia, which means you might have gaps in your memory for events that occurred close in time to the course of ECT. This type of memory loss may extend back several months or years. However, retrograde amnesia usually improves during the first few months after ECT.

A patient affected by anterograde amnesia is temporarily less able to remember what he or she has experienced for three months after treatment. Most people’s confusion clears up quickly, and memory loss usually goes away entirely within a few months.

Does Electroconvulsive Therapy Work for Addiction?

Electroconvulsive therapy (ECT) is a non-medication treatment of addiction-related mental problems, including methamphetamine dependence. ECT is primarily used to treat severe mental health conditions, such as depression, schizophrenia, and bipolar disorder.

Does Electroconvulsive Therapy Work for Depression?

Electroconvulsive therapy (ECT) is a highly effective treatment for major depression, with clinical evidence indicating that for individuals with uncomplicated, but severe major depression.

This treatment involves sending electrical pulses to the brain through electrodes while the patient is under anesthesia and is highly effective, giving some patients full reversal of depression symptoms. More than 70 percent of depressed people who receive ECT respond favorably.

A study of 39 people with treatment-resistant depression found that ECT was effective in reducing symptoms in 64% of participants. Additionally, ECT is highly effective in ameliorating depression symptoms with fewer unwanted effects and is becoming a preferred depression treatment due to its high efficacy and safety profile.

After 2 to 3 weeks, 71% of people who received ECT had a positive response to treatment, compared to only 28% who received antidepressants. However, relapse following successful ECT for major depression is common, with up to half of all patients who respond to ECT experiencing a relapse within the first year, the period of highest risk being the first 6 months.

Get Treatment At The Grove

Addiction treatment is a multifaceted journey that requires a comprehensive approach, combining medical, psychological, and supportive therapies to address the complex nature of addiction. At The Grove, individuals seeking recovery are offered a range of customized treatment options designed to meet their unique needs.

The Grove’s team of experts specializes in various evidence-based therapies, including Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and specialized programs like Habit Reversal Therapy and Electroconvulsive Therapy for more challenging cases. This integrative approach ensures that each aspect of addiction is addressed, from the physical dependencies to the psychological triggers. Get consultation from our experts and start your path to recovery today.

The Grove Editorial Team is a dynamic group of professionals at The Grove, a leading addiction treatment center in Indianapolis, Indiana. Comprising experienced therapists, medical experts, and dedicated support staff, this team brings a wealth of knowledge and compassionate insight into the complexities of addiction and recovery. Their collective expertise shines through in each article, offering readers valuable guidance, the latest in addiction science, and inspiring stories of healing and transformation. The Grove Editorial Team is committed to educating, supporting, and empowering individuals and families on their journey toward a healthier, substance-free life.

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