Electro-convulsive therapy (ECT) is a safe and effective psychiatric treatment. It is done by passing an electric current for about one second between two electrodes, which have been applied to the patient's scalp. This induces a seizure, which usually lasts about thirty seconds. The seizure results in therapeutic alterations in the patient's brain chemistry.
It was first used in Italy in 1938 and, because it proved to be so effective, within a few years was widely used in Europe and the United States. During the 1940s and '50s a great many people benefited from this treatment. Nevertheless, because of people's natural fear of electricity, popular movies and novels such as One Flew Over the Cuckoo's Nest, which depicted the abuses of ECT, and the availability of new drugs, the use of ECT greatly declined during the 1960s.
However, it soon became apparent that medications often failed and many patients who did not respond to medication had a very good response to ECT. Also, ECT techniques greatly improved. Patients were attached to monitors and given oxygen during the treatment, muscle relaxants were used to prevent injuries, and electrode placements and electrical doses were changed to reduce cognitive side effects. Thus, despite strong opposition from anti-ECT groups, ECT use from the 1980s to the present has been increasing. At this time it is generally recognized as an extremely effective treatment for severe depression, mania and psychotic conditions that have not responded to other treatments.
Just a few years ago, to receive ECT, a patient had to be admitted to a psychiatric hospital. Today many patients can be treated without being hospitalized, as ECT is becoming more available as an ambulatory treatment.