Neuropsychiatric Adverse Effects of Electroconvulsive Therapy: A Retrospective Study

Electroconvulsive therapy (ECT) is an important treatment modality in psychiatry. Despite the efficacy of ECT, its use worldwide is less than expected. Although limited access and stigma are the main factors contributing to this controversy, cognitive side effects are an important issue for clinicians who administer ECT. The present study aims to provide an assessment of the frequency of neuropsychiatric adverse effects associated with ECT.

A retrospective evaluation of 2935 files of patients who underwent ECT between January 1, 2013 and December 31, 2017 was performed. Specific data obtained from patient records, such as sociodemographic characteristics, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnoses, scale scores, medical evaluations, length of hospital stay, previous ECT history and indications for ECT administration, stimulus parameters, seizure duration, and neuropsychiatric adverse effects were evaluated.

A significant proportion of patients experienced no neuropsychiatric adverse effects across multiple sessions, with the proportion increasing steadily from 70.7% after one session to 97.3% after ten sessions. Additionally, the group that showed neuropsychiatric adverse effects underwent a significantly higher number of previous ECT sessions (p<0.001), longer duration of hospitalization after the last ECT session (p<0.001), and overall duration of hospitalization (p<0.001).

The fact that the majority of patients in this study did not experience any neuropsychiatric adverse effects during more than one ECT session and that the frequency of adverse effects decreased as ECT sessions progressed may contribute clinicians to approach ECT application more confidently.