What We Do

What is ECT

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.

How ECT Works

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.

How Long is the Full ECT Treatment

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.

Risk of Side 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.

How to access ECT

Currently, the ECT program is only accepting internal referrals within UHN. If interested, please speak to your UHN Psychiatrist.​

 Your Procedure

How to Prepare

Before undergoing ECT, our team and your psychiatrist will guide you through the preparation process:

  • Your doctor will explain the procedure and answer your questions. You and/or your substitute decision-maker will need to provide written consent to have ECT.
  • You will meet with an anesthesiologist.
  • You may need further medical evaluation (as advised by your psychiatrist or anesthesiologist), which may include blood tests and an electrocardiogram (ECG) to make sure your heart is healthy for the procedure.
  • Do not eat or drink after midnight on the day of your treatment. Your medical team will advise if you can still take any medication you are currently prescribed. Usually, blood pressure medications can be taken the morning of with a sip of water.
  • Arrival time at the Surgical Admission Unit (SAU) is 7:30 am – SAU staff will check you in, have you change into a gown and direct you to sit on a stretcher to be taken to the treatment room.
  • It is mandatory for outpatients to have a chaperone present for each treatment to drive home safely.

During ECT

  • Arrive in the treatment room in the Post Anesthesia Care Unit (PACU). Your chaperone will remain in a waiting area.
  • A healthcare provider will put an intravenous line (IV) into your arm.
  • Your heartbeat, blood pressure, oxygen levels and brain activity will be closely monitored throughout the entire procedure. You will receive oxygen through an oxygen mask.
  • You will receive anesthesia through your IV to help you fall asleep and relax your muscles and you will remain asleep during the treatment (approx. 5-10 minutes).
  • Two electrodes (small metal discs) will be placed on the surface of your scalp and/or temple. These electrodes carry the electrical current through part of your brain. The current lasts from 1 to 4 seconds. It will cause a controlled therapeutic seizure (your muscles will tighten and then relax) that usually lasts 20 to 60 seconds. The procedure itself is brief, lasting only a few minutes.

After ECT

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.

Follow Up Management

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.​

 Meet Our Team

ECT Medical Lead: Dr. Rickinder Sethi

ECT Staff Psychiatrists:

  • Dr. Kathleen Bingham
  • Dr. Antonia Cappella
  • Dr. Alistair Flint
  • Dr. Jody Morita
  • Dr. Vanessa Thoo​
Back to Top