Treating Depression With Electroconvulsive Therapy

By Sarah Hollingsworth Lisanby, MD Professor and Chair, Department of Psychiatry and Behavioral Sciences Director, Brain Stimulation and Neurophysiology Center Duke University School of Medicine

Posted on | By Sarah Hollingsworth Lisanby, MD | Comments ()

Does ECT damage the brain?

No. Careful studies using sensitive brain imaging measures in people receiving ECT, and precise anatomical measurements in animal research studies, have repeatedly demonstrated that ECT does not damage the brain.

How has ECT been modernized over the years?

Medical advances have dramatically modernized ECT, improving its safety. These advances include general anesthesia, the switch to safer types of electrical stimulation (such as the ultra-brief pulse stimulus and the ability to customize the stimulus dose to each person receiving ECT), and the use of right unilateral electrode placement. Each of these advances has substantially improved the safety of ECT. 

What about brain stimulation without inducing a seizure?
There are a number of ways to stimulate the brain with electrical and magnetic fields without causing a seizure. The only one of these procedures that is currently FDA approved for clinical depression is transcranial magnetic stimulation (TMS).

TMS uses magnetic fields to produce small electrical currents in specific areas of the brain for the treatment of depression. TMS may be indicated when a person fails to respond to one (but not more than one) adequately dosed antidepressant medication in the present episode of depression. In contrast, ECT is effective even after multiple medications have failed to improve depression. TMS is more commonly used for less severe cases of depression, while ECT remains an effective treatment for severe, medication-resistant depression. 

Sarah Hollingsworth Lisanby, MD

Article written by Sarah Hollingsworth Lisanby, MD
Professor and Chair, Department of Psychiatry and Behavioral Sciences Director, Brain Stimulation and Neurophysiology Center Duke University School of Medicine