Electro-convulsive therapy

which seizures are electrically induced in anaesthetised patients for therapeutic effect.
Today, ECT is most often used in treatment resistant
Mania (often in bipolar disorder)
Catatonia and schizophrenia

It was first introduced in the 1930s
Today, an estimated one million people worldwide receive ECT every year usually in a course of 6-12 treatments administered 2or3 times a week.
ECT not known to give rise to long term side effects.
It is safe in all three trimesters in pregnancy.
Relative contraindications include recent cerebro-vascular accident (stroke), heart disease and phaeochromocytoma.


Intra-venous access
Patient is ventilated
Short acting intra-venous anaesthetics
Intra-venous muscle relaxant
Brain stimulation (unilateral /bilateral electrode placement)

Mechanism of action:

Increase blood supply to brain
Down grading of anxiety (beta) receptors
Increase brain derived neurotropic factor (BDNF)
Formation of new blood vessels in the brain