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ECT, or Electroconvulsive Therapy, is a treatment that causes the brain to have a generalized, or "grand mal" seizure under medically controlled conditions. It is performed under the guidance of two doctors, a psychiatrist, and an anesthesiologist. Each treatment is done while the patient is asleep (with general anesthesia), and takes only minutes to complete. A series of treatments can be performed on an inpatient or outpatient basis, depending on the need of the patient. It is a treatment option for patients who are diagnosed with a range of serious mental illnesses, especially patients with severe depression.
Our state-of-the-art ECT technology allows treatment with ultra-brief stimulation. Due to the new technology’s more gentle effects on memory, we may be able to provide a more sustainable, long-term maintenance treatment.
A psychiatric evaluation is performed to determine the appropriateness of ECT treatment. Patients also receive a medical evaluation, including a physical examination, blood tests and an electrocardiogram (EKG) before beginning ECT.
The number of treatments recommended is based on the individual patient’s needs and responsiveness to the procedure. Patients come two to three times per week and usually receive between four and twelve treatments per episode of care. The patient is put to sleep with a short-acting anesthetic. A muscle relaxant is then administered, followed by a low-voltage electrical shock to the brain of the patient to cause a seizure. This is theorized to improve the chemical pathways in the brain, permitting an adjustment of nature’s neuro-transmitters that affect mood and behavior. The patient is usually fully awake 10 to 20 minutes after falling asleep.
Some patients may have a need for maintenance ECT, as 20 to 50 percent of the people who respond well to a course of ECT may relapse within six months. Therefore, a maintenance treatment of medications and/or ECT might be advisable.
ECT is provided on both an inpatient and outpatient basis. The treatment is administered in Suburban Hospital’s 4th floor Minor Procedures Suite.
ECT is considered one of the safest treatment options for medically fragile patients, including the elderly, pregnant women, and patients who have limited tolerance to some psychiatric medications. As with all forms of medical treatment, some patients may experience adverse side effects. There is a potential for memory problems, headache, or confusion in some patients, and in rare cases, death. Other side effects may include muscle soreness, nausea, temporary irregularities in heart rate and, in a few instances, damage to fragile teeth. Some patients prefer to sleep for a few hours following treatment.
Susan G. Kozauer, MD, is Suburban Hospital’s Associate Medical Director of ECT Services. Dr. Kozauer is a board-certified Adult Psychiatrist who is certified by the Association for Convulsive Therapy. Dr. Kozauer will coordinate and communicate with patients and the referring physicians regarding goals and progress throughout the course of treatment. With written consent from patients, Dr. Kozauer can also speak to others, such as family members.
If you have questions about inpatient or outpatient ECT services, please call Gloria Martin, RN, MPA, CAC, Program Director, at 301.896.2331.