[Electroconvulsive therapy and its mechanism of action]

Electroconvulsive therapy (ECT) is known as an effective treatment for some depressive disorders. Nevertheless ECT continues to be a subject of controversy. The absence of a unifying theory for its mechanisms of action explains the mistrust about ECT. The aim of this article is to review the literature about ECT and to propose a synthesis concerning its mechanisms of action. At the present time, the most reliable hypothesis suggests selective activations of central serotonergic and dopaminergic systems on the one hand, and a direct stimulation of the neuroendocrine neurons on the other hand.