Electroconvulsive therapy--efficacy and side-effects.

Area of Science:

• Psychiatry
• Neurology
• Clinical Psychology

Background:

• The efficacy and side effect duration of electroconvulsive therapy (ECT) remain subjects of uncertainty.
• There is a need to understand the indications, effectiveness, response times, and adverse effects associated with ECT.

Purpose of the Study:

• To investigate the indications for ECT.
• To evaluate the efficacy and time to response for ECT.
• To assess the side effects of ECT.

Main Methods:

• Systematic assessment of ECT protocols and medical records from 1960-1995.
• Data collected from three psychiatric wards at Dikemark Mental Hospital, Norway.

Main Results:

• 141 patients underwent 241 ECT series (1960 sessions); major depressive disorder was the primary diagnosis (88%).
• 85% of patients recovered within four weeks of the first ECT; 77% showed improvement within six days.
• 51% of ECT series had noted side effects, with five serious complications; ECT was considered safe and well-tolerated.

Conclusions:

• ECT demonstrates good immediate efficacy with rapid signs of recovery, particularly in the first week.
• Depressed psychotic patients and the elderly appear to respond best to ECT.
• ECT is a relatively safe and well-tolerated treatment for patients with serious and long-lasting psychiatric disorders.