ECT has been around for more than 50 years yet there remains a great deal of concern regarding its use. In my opinion, bollywood films have been the single biggest reason for demonising ECT in public eye. Recent Salman Khan starrer "kyoon ki" is a case in example.ECT is one of the most effective (sucess rate approaching 80%) and fast acting (results can be seen as soon as after the first treatment) treatments of depression. Stopping the use of ECT in would deprive certain patients of a potentially effective treatment, which in certain circumstances may be life saving.

What does the treatment involve?

• ECT involves placing an electrical pulse to the patient's head to cause a carefully controlled fit or seizure.
• The treatment is performed under full general anaesthetic so that the patient is unaware of the seizure. A muscle relaxant is also given to reduce the shaking movements and prevent injury.
• The treatment is usually given twice a week.
• A course of ECT usually comprises between 6 and 12 treatments.
• Most people are hospitalised for the duration of treatment, but it is possible to receive ECT as an outpatient.

How does it work?

• ECT arose from many different observations, including doctors realising that patients with epilepsy and depression tended to be less depressed after having a fit or seizure.
• Depression is caused by a fall in some brain chemicals and ECT appears to increase these brain chemicals.
• The precise way in which ECT works remains unknown, but it is no less effective for this.

Indications for ECT

• ECT is considered the treatment of choice in severely depressed patients when other forms of medication have either not worked, caused side effects the patient cannot cope with, or will not help the patient quickly enough (for example if the person is not eating and drinking or is severely suicidal).
ECT is also an effective treatment for schizophrenia and mania, but is only occasionally used for these conditions.

Risks

• ECT is no more dangerous than minor surgery under general anaesthetic, which has a death rate of approximately 1 in 10,000. It is performed under the care of an anaesthetic consultant or specialist, who administers the general anaesthetic and monitors the patient during the procedure.

Common side effects

• Many patients report patchy but persistent memory loss just before and during ECT treatment. There is some evidence of long-term memory problems following ECT.
• Many people experience confusion on waking up from the anaesthetic, but this clears within a few hours.
• The ability to learn new information is impaired for several weeks after ECT treatment, but does return to normal over time.
• Some people suffer from headaches and muscle aches straight after treatment and these respond well to common painkillers such as paracetamol.

Does ECT cause lasting brain damage?

• The amount of electricity applied to the scalp and the lesser amount that reaches the brain is too small to cause lasting brain damage.
• Researchers specifically looking for evidence of brain damage have not found any.
• Furthermore, people who suffer from epilepsy and have fits spontaneously (under much less carefully controlled conditions) do not develop lasting brain damage unless the fits are prolonged. .