Electroconvulsive Therapy (ECT)

Northern Light Acadia Hospital is the only program in eastern and northern Maine to provide Electroconvulsive Therapy (ECT), and the only program in central Maine to offer ECT as part of a full continuum of care.

Electroconvulsive therapy, or ECT, can provide rapid, significant improvements in severe symptoms of several mental health conditions. ECT is used to treat a variety of conditions including:

  • Severe depression, particularly when accompanied by detachment from reality (psychosis), a desire to commit suicide, or refusal to eat.
  • Treatment-resistant depression, a severe depression that doesn't improve with medications or other treatments.
  • Severe mania, a state of intense euphoria, agitation, or hyperactivity that occurs as part of bipolar disorder. Other signs of mania include impaired decision-making, impulsive or risky behavior, substance use, and psychosis.
  • Catatonia, characterized by lack of movement, fast or strange movements, lack of speech, and other symptoms. It's associated with schizophrenia and certain other psychiatric disorders. In some cases, catatonia is caused by a medical illness.
  • Agitation and aggression in people with dementia, which can be difficult to treat and negatively affect quality of life.

ECT may be a good treatment option when medications aren't tolerated, or other forms of therapy haven't worked. In some cases ECT is used:
  • During pregnancy, when medications can't be taken because they might harm the developing fetus
  • In older adults who can't tolerate drug side effects
  • In people who prefer ECT treatments over taking medications
  • When ECT has been successful in the past

Our service is easy to access and provides a friendly and comfortable environment for our patients and his or her family members. We also provide family education, which enhances the patient’s recovery.

To learn more about Northern Light Acadia Hospital’s ECT program, call our Behavioral Health Resource Center at 207.973.6100 and we will be glad to connect you with a member of our experienced and compassionate ECT team.
 

Frequently Asked Questions about Electroconvulsive Therapy (ECT)

Electroconvulsive therapy (ECT) is a relatively safe and effective treatment that involves passing a small and carefully controlled electrical current through a person’s head to produce a seizure in the brain. This causes changes in brain chemistry that can relieve symptoms of certain psychiatric disorders such as depression. The procedure is painless and is always performed under general anesthesia.

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Yes. ECT has been used for over 70 years. In the United States, about 100,000 individuals receive ECT each year, and the numbers are increasing every year. The National Institute of Mental Health, the American Psychiatric Association, and the U.S. Surgeon General all have endorsed ECT as a valuable treatment for certain mental illnesses, particularly for major depression.

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Antidepressant medications and psychotherapy are often effective treatments but can take time to work. This delay can be dangerous for severely depressed patients who have intense suicidal thoughts or suffer from psychosis. ECT works faster than antidepressants and is a valuable treatment when patients are at risk for suicide. ECT can also be used when patients do not respond to antidepressant medications or cannot tolerate antidepressants, especially in elderly patients. Patients suffering from bipolar disorder and schizophrenia may also benefit from ECT. ECT is often a treatment of choice in severely depressed pregnant women who don’t want to expose the fetus to antidepressant medications.

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A treatment team administers ECT. The team consists of psychiatrists, nurses, and certified registered nurse anesthetists. ECT is administered in a special unit at Northern Light Acadia Hospital. This unit includes a waiting area, a treatment room, and a recovery room. ECT can be done either on an in-patient or out-patient basis.

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ECT is given under general anesthesia. Patients are asked not to eat or drink from midnight the night before ECT. Before the treatment an intravenous line is inserted for giving medications. During the procedure, the patient receives a short acting anesthetic agent which puts the patient to sleep for about 5-10 minutes.

Once the patient falls asleep, a muscle relaxing medication is given to the patient to stop the muscles from moving during the seizure. When the patient is completely asleep and the muscles are well relaxed, a small electrical current is applied to the electrodes on the head. This stimulates the brain and produces the seizure, which lasts for about 15 seconds to two minutes.

Throughout the procedure, vital signs, heart rhythm, and brain electrical activity are closely monitored and the patient receives oxygen through a mask. When the treatment is completed, the patient is taken to a recovery area for monitoring by trained staff. Usually within 30 to 60 minutes, the patient can leave the recovery area. 

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ECT is given two to three times a week, on Monday, Wednesday, and Friday, for a total of six to twelve treatments. Some patients may need more or fewer treatments. Once symptoms are resolved, ECT is usually discontinued.

Continuation/maintenance ECT is recommended for patients whose depression has not responded well to medications (treatment-resistant depression) or patients who are unable to tolerate antidepressants. It is usually given for a period of several months with each treatment separated in time by one or more weeks. Continuation/maintenance ECT is expected to prevent the return of the psychiatric condition.

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The most common side effects are headache, nausea, muscle aches, disorientation and confusion. The confusion typically clears within one hour. Patients may develop memory problems such as difficulty in learning and retaining new information and remembering events that have happened before and while receiving ECT.

Memory problems especially ability to learn and form new memories improve in the weeks and months following the last ECT treatment. In some people, the memory problems can be more severe and irreversible. Unilateral ECT, a type of electrode placement, has been shown to have less incidence of memory impairment.

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Informed consent for ECT is obtained in writing after an explanation of the procedure, its potential benefits, risks, and side effects, and a description of available alternative treatments. Patient can withdraw their consent at any time. Legal guardians can provide informed consent for patients unable to participate in the informed consent process.

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