What to Expect

Preparing for Electroconvulsive Therapy Treatment

As with any other surgical procedure, patients may have nothing to eat or drink after midnight the night before their electroconvulsive therapy (ECT) treatment. On the day of the ECT appointment, they should bring their insurance information and picture identification. Since patients will receive general anesthesia, they must not drive for 24 hours after their ECT treatment. Therefore, they will need a responsible adult to drive them home and remain with them for 24 hours.

What to Expect During Treatment

Upon arrival to the ECT Suite, the admission process takes place in one of the private rooms. An ECT nurse will obtain the patient’s vital signs and insert an IV. The psychiatrist conducts a pre-procedure assessment of the patient’s symptom severity and the anesthesiologist completes a pre-anesthesia evaluation.

When the admission is completed, the patient is transported into the treatment room. The anesthesiologist administers an anesthetic and a muscle relaxant through the IV. After the patient is asleep and the muscles are relaxed, the psychiatrist delivers an electrical stimulus, based upon the patient’s age and gender. The stimulus produces a mild seizure that usually lasts less than 60 seconds. Body movement during the seizure is minimal because of the muscle relaxant. The ECT machine measures changes in brain activity during the seizure.

The anesthesiologist monitors vital signs and provides supplemental oxygen throughout the procedure. When the patient is breathing well independently and vital signs are stable, the patient is transported back to the private room where the Post Anesthesia Care Unit (PACU) nurse is waiting.

Recovery

The PACU nurse is with the patient throughout the recovery period. Vital signs are monitored every 15 minutes. Complaints of pain or nausea are addressed by the psychiatrist and anesthesiologist. Medications for pain and/or nausea will be offered if indicated. Once the patient is alert and oriented, food and drink are provided.

Recovery time after the treatment is generally one hour. During the recovery period, the patient’s transportation is contacted and asked to return to the ECT suite. Home-going instructions provide details on post-treatment dos and don’ts, contact phone numbers and next appointment date and time.

Typical Number of Treatments Needed

A small number of patients may experience significant improvement of their symptoms after one or two treatments, but the majority of patients need four two six treatments for noticeable improvement and six to twelve treatments for remission. Treatments for the acute series take place on Monday, Wednesday and Friday. It is crucial for patients to attend all these treatments for a speedy recovery. ECT treatments twice a week are acceptable for those who have serious memory problems or transportation difficulty. Missing treatments during the acute series may cause setbacks in their progress.

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