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Electroconvulsive Therapy (ECT) is a safe and effective medical treatment for individuals dealing with severe depression, bipolar depression, psychosis, schizophrenia and other mental health conditions. ECT is a well-established procedure that can provide significant relief to patients who have not responded to other forms of treatment (such as medication or psychotherapy). ECT can be used to treat people with acute illness and to maintain their improvement.
ECT works by providing a medically monitored and controlled seizure under the supervision of an anesthesiologist, psychiatrist and experienced nursing staff. ECT is a carefully administered medical treatment that involves the application of a controlled electric current to the brain, leading to brief seizures. ECT seems to cause chemical changes in the brain, regulating the brain's neurotransmitters and improving communication between different regions. These changes can improve the symptoms of some mental illnesses.
ECT may help improve the patient's symptoms, but it is not a cure. Patients will still need ongoing treatment to prevent their symptoms from returning, which may include medication or psychotherapy, and possibly ongoing ECT treatments.
ECT treatment typically consists of a series of sessions called a “course”, depending on the patient's individual needs and response to treatment. The frequency and duration of sessions will be determined by their UHN provider, but an acute course is typically 2 to 3 times a week for 6-12 sessions; the number of treatments may depend on the severity of the patient's symptoms and how quickly they improve. Some patients respond positively after the first 2 to 3 treatments, though full improvement usually takes longer. There may be recommendations for maintenance or booster treatments of ECT to help maintain the positive effects.
Potential physical side effects include headache, muscle pain, jaw pain and nausea. These side effects normally go away after a few hours and can be treated with medicine, if needed.
The patient may feel confused immediately after treatment. It is best for them to rest for the next 24 hours and have someone with them during this time. The confusion caused by anesthetic or ECT usually subsides within a short period. Rarely, it can last a couple of days or longer.
ECT can affect the patient's memory and may lead the patient to forget past events or cause difficulty learning new things. Some patients may not remember having the procedure done. ECT's effect on memory is typically short-lived and does not involve forgetting loved ones or major events that happened in the past. If memory problems develop, they may last a few weeks or months. We also suggest not making any large life decisions during the acute course of ECT. In rare cases, memory loss can be permanent. Improved ECT techniques and clear guidelines for the use of ECT have reduced the risk and severity of memory side effects.
Currently, the ECT program is only accepting internal referrals within UHN. If interested, please speak to your UHN Psychiatrist.
Before undergoing ECT, our team and your psychiatrist will guide you through the preparation process:
Following the procedure, you will be monitored until the effects of the anesthesia wear off, then transferred to the Post Operative Care Unit (POCU). The nursing team will continue to monitor your blood pressure, oxygen level, heartbeat and breathing. After resting, you may eat and return to your daily routine although some patients will need to rest for several hours. You cannot operate any machinery including driving, and your chaperone will need to transport you home. If safe and stable, the departure time from POCU is 9:00 am.
Your UHN psychiatrist will monitor the benefits and side effects of the ECT course. As a team, the UHN psychiatrist will collaborate with you, your family (if applicable) and the ECT treatment team to decide the best lead placement and number of treatments for the acute course and if indicated, ongoing maintenance/continuance treatment.
ECT Medical Lead: Dr. Rickinder Sethi
ECT Staff Psychiatrists:
You will be contacted with information about your first appointment.
Please bring the following to your appointment. Not all of these items may be needed for your appointment. Our clinic or your referring doctor will let you know what you must bring.
Please arrive 15 minutes before your appointment.
When you arrive, you will sign in with the receptionist. You will need your health card (OHIP card) to sign-in. If you do not have an OHIP card, please bring another form of government-issued photo ID, such as a driver’s license or passport.
You may be given a Measuring Health Equity Questionnaire to fill out. This form contains questions about your background. We collect this information to find out who we serve and what unique needs you may have. The form is voluntary and you can choose ‘prefer not to answer’ to any or all questions. However, the information you choose to give us will help us improve the quality of care for you and others.
First appointments take longer than follow-up appointments. Your first appointment can take 2 hours or more. Follow-up appointments usually take 15 to 30 minutes. We do everything we can to stay on time but sometimes unforeseen circumstances may delay your appointment.
At the end of your first appointment, the nurse or doctor will give you a contact list for your health care team. If you don’t get a contact list, feel free to ask for it.
After every appointment, a member of your health care team will tell you about your next visit. Be sure you understand what is going to happen next. For example, know the time and place of your next visit or if someone will call you with this information.
If you are unsure about what your next steps are, don’t be afraid to ask a member of your team. We are here to help you.
We understand that reaching us by phone can sometimes be difficult. Often our phone lines are busy or are turned over to the message centre so our staff can prepare for clinic visits or help other patients. We make every effort to return your call within 24 hours. Our staff will try to reach you 2 times. If we are not able to reach you directly you may need to call us again.