I was given this hand out explaining ECT while hospitalized at Johns Hopkins.

ECT Procedure

ECT involves a series of treatments. For each treatment, you will be brought to a specially equipped room in this hospital. The treatments are usually given in the morning, before breakfast. Because the treatments involve general anesthesia, you will have had nothing to drink or eat for at least 6 hours before each treatment, unless special orders have been written by the doctor to receive medicines with a sip of water. An intravenous line (IV) is placed in your arm so that medicines that are part of the procedure can be given. One of these is an anesthetic drug that will quickly put you to sleep. When you are asleep, you are given a second drug that relaxes your muscles. Because you are asleep, you do not experience pain or discomfort during the procedure. You do not feel the electrical current and when you wake up you have no memory of the treatment.

To prepare for the treatments, monitoring sensors are placed on your head and chest. Blood pressure cuffs are placed on one arm and one ankle. This enables the physician to monitor your brain waves, heart, and blood pressure. These recordings involve no pain or discomfort.

After you are asleep, a small, carefully controlled amount of electricity is passed between two electrodes that have been placed on your head. Depending on where the electrodes are placed, you may receive either bilateral ECT or unilateral ECT. In bilateral ECT, one electrode is placed on the left side of the head, the other on the right side. When the current is passed, a generalized seizure is produced in the brain. Because you will be given a medication to relax your muscles, muscular contractions in your body that would ordinarily accompany a seizure will be considerably softened. You will be given oxygen to breathe. The seizure will last for approximately one minute.

Within a few minutes, the anesthetic drug will wear off an you will awaken.

You will be brought to a recovery room, where you will be observed unfit you are ready to leave the ECT area and return to the unit.

Frequently asked questions about ECT...

1.Will the procedure hurt?

No. Prior to getting ECT you will receive a muscle relaxant to prevent muscle strain from the seizure and general anesthesia so no pain is felt.

2.Why has my doctor recommended ECT for me?

ECT is recommended for patients will drug resistant affective disorders and patients who are acutely suicidal and at high risk of harming themselves.

3.How effective is ECT?

ECT is proven to be effective in about 80% of people receiving it. This is more promising than most anti-depressants.

4.Is it dangerous? And how do you know if it is safe for me?

The risks of ECT are about equal to that of minor surgery with general anesthesia. About I death occurs in 10,000 patients receiving ECT. The procedure itself is administered by an experienced team of clinicians and is carefully monitored. Many
pre-ECT tests will be done to make sure ECT is safe for you. This includes blood tests, general physical, mental status exam, and an anesthesia consult. Chest x-rays and an ECG are done for older patients.

5.Doesn't ECT make you lose your memory?

ECT causes short term memory disturbances. Long term memory is generally not affected. You may forget events surrounding the procedure and even things that happen a few days before and in between treatments. It will be difficult to remember things. This clears up in a few weeks after treatments with a return to pre-treatment functioning in 3-6 months.

6.Does it cause brain damage?

No. Research shows that ECT does not cause any cellular or neurological changes in your brain.

7.What other side effects might I experience?

Along with memory disturbances, you may experience confusion, muscle soreness, headache, and nausea. Inform your doctor or nurse if you experience any of these.

8.How many ECT treatments will I need?

A series of 6-12 treatments is recommended for the greatest effect. Your doctor will decide how many are best for you.

9.Why can't I eat or drink before the treatment?

As with a surgical procedure you should have nothing in your stomach so as to prevent anything from coming up and choking you.

10.How long does the procedure take?

The procedure takes about one hour from the time you leave the unit to the time you return. The seizure itself will only last 20-90 seconds. The rest of the time is for preparation for and recovery from the procedure.

11.When will I notice improvements from ECT?

Most people will notice improvements in their symptoms in about one to two weeks

Information Obtained From The Johns Hopkins Hospital, Baltimore, Maryland.

• Patient Information
• Affective Disorders Program Information
• ECT Information

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