Electroconvulsive therapy (ECT) may be used when a person with schizophrenia does not respond to antipsychotic drugs. It is not a first-line treatment and is used only for severe symptoms.1
What is ECT?
ECT involves sending controlled electrical currents to the brain. The electricity causes a small seizure. The seizure is meant to change the balance of certain chemicals in the brain. This can help stop symptoms quickly.2-4
ECT is most commonly used for severe, treatment-resistant mental health conditions. These include depression and bipolar disorder as well as schizophrenia. It also may be useful in treating agitation or aggression that stem from dementia in older adults.2,3
Since it does not use any drugs (besides anesthesia), ECT can be helpful for people who should not take medicine. This may include pregnant women and older adults who tend to have more drug side effects and risks.2,3
How does ECT help treat schizophrenia?
The exact way ECT helps improve schizophrenia symptoms is not known. Experts think these symptoms may be caused by an imbalance of certain chemicals in the brain. These chemicals are called neurotransmitters. The brain uses neurotransmitters to communicate to the rest of the body. They help control many important functions.2
Dopamine is an example of a neurotransmitter thought to be involved in schizophrenia. Antipsychotic drugs can take weeks to start changing the balance of neurotransmitters in the brain. But ECT may change this balance and improve symptoms quickly. Much more research is needed to understand the true effects of ECT on schizophrenia.1,2,5
ECT is also used for people with catatonia. People with catatonia have a variety of motor and speech symptoms. These symptoms may include repetitive movements, mimicking speech, and a complete lack of response to others. Catatonia can be a symptom of schizophrenia. But it also can be caused by other health conditions or drugs.1-4
Does ECT cure schizophrenia?
ECT is not a cure for schizophrenia. It is used only for severe symptom management. ECT’s effects are time limited. This means that the symptoms it treats typically return after some time passes.Even after a successful course of ECT, a person will still need to continue their previous treatment plan. This includes taking antipsychotic drugs and/or attending therapy.2,4
What to expect during ECT
Before the procedure, you will receive general anesthesia that puts you to sleep. Usually, you are not allowed to eat or drink after a certain time the day before receiving anesthesia. Your doctor will tell you when to stop eating or drinking before your ECT appointment.2-4
During the treatment, you receive the anesthesia drugs through an IV. Electrode pads are placed on your head. The electrical currents will be delivered to your brain through these pads. When you are asleep and your muscles are relaxed, the currents create a short seizure. The seizure lasts about 60 seconds.2
The whole treatment lasts about 5 to 10 minutes. You are monitored the entire time. Most people have a few treatments per week for several weeks. A typical treatment plan may have 6 to 12 treatment sessions. But each person’s plan is different and based on their symptoms.2,4
What are the possible side effects of ECT?
There are a few potential side effects of ECT. Most of them are mild, but each person’s experience is different. Common risks and side effects of ECT include:2-4
- Trouble with memory – Some people have trouble remembering things that happened before their treatment. Fuzzy memories can come from minutes, days, or weeks before. This type of memory loss is called retrograde amnesia. It impacts memory only from before the treatment. Memory problems tend to get better in the months after treatment ends.
- Confusion – It is common to feel confused right after an ECT treatment. This can last for several minutes to several days. The risk of confusion rises with a person’s age at the time of treatment.
- Physical discomfort – A few physical effects can result from the electricity and seizure during ECT. These include headaches, jaw pain, muscle aches, and nausea.
- Heart issues – Heart rate and blood pressure can increase during ECT. People with heart conditions may not be able to have ECT.
These are not all the possible side effects of ECT. Talk to your doctor about what to expect from ECT. You should also call your doctor if you have any changes that concern you about ECT.
Other things to know
In the past, ECT was thought to be unsafe. This was because doctors delivered high doses of electricity and did not use anesthesia. Results included injuries and memory loss. Today, ECT is highly controlled and performed by trained professionals. It is considered a safe option for people with treatment-resistant schizophrenia.2
But anesthesia carries its own risks. Some people may not be well enough to undergo anesthesia. Talk with your doctor about whether it is safe for you. In most cases, they will do a physical exam and complete evaluation before ECT. This can help you both identify risks before the treatment.2,3
Before beginning treatment for schizophrenia, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.