This leaflet is for anyone who wants to know more about electroconvulsive therapy (ECT). It discusses how it works, why it is used, its effects and side-effects, and alternative treatments.

Electroconvulsive therapy remains a controversial treatment and some of the conflicting views about it are described. If your questions are not answered in this leaflet, there are some sources of further information at the end of the leaflet.

Where there are areas of uncertainty, we have listed other sources of information that you can use. Important concerns are the effectiveness and side-effects of ECT and how it compares with other treatments. At the time of writing, these references are available free and in full on the internet.

What is ECT?

Electroconvulsive therapy is a treatment for a small number of severe mental illnesses. It was originally developed in the 1930s and was used widely during the 1950s and 1960s for a variety of conditions. It is now clear that ECT should only be used in a smaller number of more serious conditions.

Electroconvulsive therapy consists of passing an electrical current through the brain to produce an epileptic fit – hence the name, electroconvulsive. On the face of it, this sounds bizarre. Why should anyone ever have thought that this was a sensible way to treat a mental disorder? The idea developed from the observation that, in the days before there was any kind of effective medication, some people with depression or schizophrenia, and who also had epilepsy, seemed to feel better after having a fit. Research suggests that the effect is due to the fit rather than the electrical current.

How often is it used?

It is now used less often. Between 1985 and 2002 its use in England more than halved, possibly because of better psychological and drug treatments for depression.

How does ECT work?

No one is certain how ECT works, and there are a number of theories.

It can change patterns of blood flow through the brain, it can change the metabolism of areas of the brain which may be affected by depression.

Many doctors believe that severe depression is caused by problems with certain brain chemicals. It is thought that ECT causes the release of these chemicals and, probably more importantly, makes the chemicals more likely to work and so help recovery.