Ever since Italian neurologist Ugo Cerletti introduced electroconvulsive therapy as a treatment for various mental disorders in 1938, this technique has come under heavy criticism, sometimes based on misinformation.
Today, and after more than 80 years of use, this therapeutic method continues to raise doubts about its effectiveness and its harmlessness. But what is the reason for this controversy? Is electroconvulsive therapy dangerous? Let us first see what this type of intervention consists of.
What is electroconvulsive therapy?
Electroconvulsive therapy (ECT) is a procedure performed under general anesthesia and consists of introduce small electrical currents into the brain in this way, intentionally triggering a brief convulsion.
This technique involves placing the patient several electrodes on the forehead and a rubber band around it where cables are connected which in turn are connected to the machine that controls and runs the electrical mechanism.
During the procedure, electric current passes from the electrodes to the brain in just a few seconds. This is what causes the seizure which usually lasts less than a minute. Since the patient is anesthetized and their muscles are relaxed, there is little or no sign of seizures and their body is usually completely still.
The ultimate goal of this therapeutic technique is causing changes in brain neurochemistry so that some of the symptoms can be quickly reversed serious mental disorders and illnesses he seeks to alleviate.
For what type of disorders is therapy indicated
The main indication for electroconvulsive therapy (ECT) is severe, life-threatening major depression or significant impairment of the individual’s functioning. Due to its rapidity of action and effectiveness, it may be the treatment of choice in severe psychiatric disorders such as catatonia, depression, bipolar disorder and psychosis.
This technique is considered the most effective and quickest acute treatment for major depression. According to randomized trials, remission occurs in 70-90% of patients on treatment.
Another specific indication for TEC is unipolar psychotic depression, people with suicidal tendencies and malnutrition secondary to food rejection, severe catatonia, as well as people with episodes of recurrent depression and treated with this therapy after numerous errors. medication.
We consider that there are no absolute contraindications to TECRegardless of the type of population and its clinical situation, except for populations at risk which must be followed under closer surveillance
Main side effects
Like any therapeutic procedure, electroconvulsive therapy is not free from possible side effects. These are the most common:
- Memory loss or amnesia
- muscle discomfort
Headaches, nausea, and muscle discomfort are usually mild and can be prevented or relieved with medication. The most unpleasant side effect is usually memory loss, While it is true that it reverses and disappears after a few weeks.
However, it should be noted that this type of side effect depends on the patient’s prior conditions, such as his age, his sensitivity to this type of treatment, the technique used or the frequency of administration.
Is Electroconvulsive Therapy Really Dangerous?
There is evidence that electroconvulsive therapy it is one of the psychiatric treatments with the highest rates of efficacy and safety to combat certain serious mental disorders.
Research concludes that the most common side effect is memory loss or amnesia. However, this therapy appears to have fewer side effects than those produced by some antidepressants and antipsychotics in frail elderly patients.
The effects this technique may have on the developing brain are still unknown.. In pregnant and breastfeeding women who are concerned about possible teratogenic sequelae (birth defects during fetal pregnancy) and other side effects of the drug, it may also be effective and can be treated safely with this treatment.
A review of 300 cases of TEC during pregnancy revealed five cases of birth defects (hypertelorism, equine varus (clubfoot), optic atrophy, anencephaly, and pulmonary cysts). The review concluded that these malformations were not the result of treatment and that there was no evidence of effects on postnatal development.
Clinical research also supports the efficacy and safety of electroconvulsive therapy as a therapeutic tool for the prevention of relapses in major depressive disorder, even in adolescents.
It therefore seems that in view of the studies and research carried out, the question of whether electroconvulsive therapy is dangerous must be answered unequivocally, at least until proven otherwise.
Effectiveness of the intervention against the disorders
Research indicates that electroconvulsive therapy (ECT) is effective in the short term for the treatment of depression, and is probably more effective than drug therapy, Be bilateral TEC (with electrodes on both sides of the head) moderately more efficient than one sided.
Studies further conclude that high doses of TEC appear to be more effective than low doses in treating serious mental illnesses such as depression and bipolar disorder. In addition, TEC has also been shown to be effective in severe bipolar depression.
TEC would also be indicated in children and adolescents suffering from severe and persistent major depression., With symptoms that are life threatening or that do not respond to other treatments. However, in this type of younger population, TEC should be used exceptionally and always performed by a qualified professional.
However, TEC is a therapy reserved only and mainly for patients with severe and persistent symptoms, especially when they have not responded to another type of treatment or when there is a real serious threat to their life.
- Gallegos J .; Vaidya P .; D’Agati D .; et al. (2012). Reducing Adverse Effects of Unmodified Electroconvulsive Therapy: Suggestions and Possibilities. The Journal of Electroconvulsive Therapy. 28 (2): 77-81.
- Fitzgerald, PB (2013). Biologic non-pharmacologic treatment approaches for difficult-to-treat depression. The Medical Journal of Australia. 199 (6): 48-51.