Electro Convulsive Therapy (ECT) – Pros and Cons of Shock Treatment
Q: Hi Doctor, my elder brother who is 23 years old has some psychiatric disorder. We consulted a psychiatrist who gave a medication, by which he was almost cured in 10 days. After that, doctor decreased his dose and prescribed a different drug. But now he is again behaving in a previous manner though not with that much of intensity. Lot of improvement is observed by us in his behavior.
After that we consulted the doctor. He said he is having a psychiatric disease and shock treatment is required. But we thought that with the 10 days medication, he was cured up to 90%. So, why can’t he be cured with medications? Is shock treatment really required? Is there any side effect of shock treatment? Can he surely get cured by shock treatment? Is it one time treatment or periodic? There is no family history of such disease. Please guide me. Thank you.
– By Prakash
Reply:
Psychiatric disorders are of many different kinds. More than 300 of them have been identified yet. To list a few, they include depressions, anxiety disorders, histrionic personality disorder, schizotypal personality disorder, some kinds of insomnia, eating disorders and many more. I need to know the details of the problem your brother has, then only I can say anything about his case.
As for shock therapy, I would not suggest your brother to go for it right now. Whatever illness he has, he should be treated with medications, counseling and compassionate support from the family.
About Electroconvulsive Therapy
Shock therapy or electroconvulsive therapy is used only in very rare cases of severe depression or catatonia. It is quite painful and has many side-effects. It is not at all desirable to go for it. Also, there is no guarantee that the patient will get alright after this therapy.
Some doctors and past patients still argue that the risks of shock therapy, such as memory loss, cognitive deficits, are too high a price to pay for the temporary benefits (if any).
Procedure of ECT
Electroconvulsive treatment is usually administered to patients in a series of treatments, ranging from six to twelve treatments over a two week period. Most of these patients are those who have had no success on antidepressants or mood stabilizing medications.
The patient’s heart rate is monitored. The procedure takes no more than ten minutes in the operating room. He receives an IV of an anesthetic (Brevital) in his arm and usually is asked to count until he becomes unconscious. Then an IV of succinylcholine is put in the arm (relaxing the muscles to prevent broken bones and cracked vertebrae), a rubber block is inserted in the mouth to prevent biting on the tongue, a mask is placed over the mouth so the brain is not deprived of oxygen and conducting jelly is rubbed on the temples and electrodes connected. The doctor presses a button and electric current shoots through the brain. A generalized seizure for 20 seconds is produced. Usually the patient wakes up in about 30 minutes.
He may or may not get alright after this treatment. There is no guarantee.
Side Effects of Shock Therapy
He can suffer from the following side-effects:
- Loss of memory- This is very common after electroshock. Patient forgets who he is, where he is and more. This condition is painful and difficult to deal with.
- He may have focal lesions due to ECT, like, his speech can get lost, he may become blind, intelligence may suffer.
- He may break his bones or vertebrae (spine) during the procedure.
- Feeling of nausea and vomiting. Pain all over the body.
There is no assurance that his underlying mental illness will get cured after the therapy.
Take Care,
Buddy M.D.
Doctor didn’t announce the name of exact disease but my brother’s symptoms are as follows:
1) Expressing anger facially.
2) Feels like confused, but not confused.
3) Fears about the successful sexual life.
4) Fear from the friends that they will fight with him.
5) If anyone said anything about him, he imagines and behaves like same (major symptom). If I said you are drug addict person then he behaves like that, but in controlled manner. When we went outside or any guest comes to home he behaves like a normal person.
6) Getting disturbed due to noise.
7) His ear getting very sensitive; while sleeping he wakes up due to little bit talking or noise.
8) worried about the examination.
9) Fears like someone done black magic.
10) Worried that he had hypnotized.
11) Some mussels weakness.
12) He was physically very weak, but now improved a lot.
13) During watching television he changed facial expressions like actor.
He leaves away from home because exams were close. He studied hard and didn’t have dinner at night to avoid sleep about 20 days before. Two weeks ago he had a party with friends where he drank and then had a food. From next day his behavior changed. He remembered each and every thing before that night. But after that night, he got confused about what happened during night.
All these things happened with him, according to current medication. He behaves like my brother, exactly like nothing happened to him. But before last couple of days, doctor changed the medication. With this behavioral changes were also observed.
Doctor said he had to be completely cured within 8 days medication; but he haven’t cured. So doctor suggested shock treatment. But we didn’t want to go for shock therapy, so previous medications are started again. And today he is behaving normally- like my brother, nothing like acting or anything.
As we said earlier, shock therapy involves lot of risks. So it would be a good idea to continue the medications under strict medical supervision. Allow some time for medications to take effect. In the meanwhile inform your doctor if you notice any deterioration in your brother’s condition.
Thanks a lot for your wonderful guidance.