While “shock therapy” has been used in psychiatry for more than 70 years, researchers had little idea how the controversial treatment worked to treat depression. Now, scientists say they may have solved the mystery.The therapy, which provides electrical stimulation to the brain and is extremely effective in treating severe depression, appears to affect how brain areas communicate with each other. It relieves “over-communication” in the brain that may make it difficult for people with depression to think and concentrate, said study researcher Jennifer Perrin, a mental health researcher at the University of Aberdeen in Scotland.
“We believe we’ve solved a 70-year-old therapeutic riddle,” said study researcher Ian Reid, a psychiatrist at the university. By understanding how the treatment, properly known today as electroconvulsive therapy(ECT), works, researchers may one day be able to replace it with something that has a lower risk of side effects, but is just as effective, Perrin said. However, such a replacement treatment is a long way off, she said.
Today, the therapy is safer because patients receive anesthesia and electricity doses are much more controlled, according to the Mayo Clinic. Still, the treatment can impair short-term memory and, in rare cases, cause heart problems.
ECT is one of the most effective treatments in psychiatry — 75 to 85 percent of patients who receive it recover from their symptoms, Reid said. That compares with about 40 percent of depression patients who recover after treatment from their primary care physician, Reid said.
Currently, ECT is used only in patients who are severely depressed and at risk for suicide, or patients who have not responded to other treatments, Reid said. In the new study, the researchers scanned the brains of nine severely depressed patients, before and after they received ECT, using functional magnetic resonance imaging (fMRI). Patients typically received eight treatments, and the final brain scan was performed about one week after the last treatment, Perrin said. All patients had previously failed to respond to antidepressants, but were successfully treated with ECT.
What Is Electroconvulsive Therapy (ECT)?
ECT is among the safest and most effective treatments available for depression. With ECT, electrodes are placed on the patient’s scalp and a finely controlled electric current is applied while the patient is under general anesthesia. The current causes a brief seizure in the brain. ECT is one of the fastest ways to relieve symptoms in severely depressed or suicidal patients. It’s also very effective for patients who suffer from mania or other mental illnesses. Although ECT has been used since the 1940s and 1950s, it remains misunderstood by the general public. Many of the procedure’s risks and side effects are related to the misuse of equipment, incorrect administration, or improperly trained staff. It is also a misconception that ECT is used as a “quick fix” in place of long-term therapy or hospitalization. Nor is it correct to believe that the patient is painfully “shocked” out of the depression. Unfavorable news reports and media coverage have contributed to the controversy surrounding this treatment.