Electroconvulsive Therapy

Introduction

Richard D. Weiner, M.D., Ph.D. Andrew D. Krystal, M.D.

Electroconvulsive therapy (ECT) is the use of electrically induced seizures for therapeutic purposes. Now, more than 60 years since its first use, ECT continues to play an important role in the management of severe mental disorders, particularly episodes of major depression (American Psychiatric Association 1994a). Despite its portrayal by some as controversial, there is evidence of increasing interest in and use of this treatment. It behooves all mental health practitioners to be aware of the indications, risks, benefits, and methodology of ECT.

The roots of ECT lie in a now-disproven hypothesis that schizophrenia and epilepsy are incompatible. In 1934, this hypothesis led the Hungarian psychiatrist Ladislaus von Meduna to chemically induce a series of seizures in patients with schizophrenia. Because at that time there were no effective treatments for schizophrenia (or for other major mental disorders), Meduna's partial success with this new "pharmacoconvulsive therapy" soon led to its widespread use (Meduna 1990).

Electroconvulsive Therapy Introduction Indications

• Contraindications and High-Risk Situations Side Effects
• Mortality
• Systemic Morbidity