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Electroconvulsive therapy

Electroconvulsive therapy

ECT at Wesley Hospital Kogarah

Wesley Hospital Kogarah uses electroconvulsive therapy (ECT) as a treatment for people experiencing severe forms of depression or other psychiatric disorders, where medication and other treatments have not been effective. It is a safe procedure that is supported by a clear body of evidence and we only use ECT with the full understanding and consent of the person involved. For the privacy and comfort of our patients, our ECT clinic includes a dedicated waiting room, treating room and recovery room.

We perform approximately 700 ECT treatments each year. And as well as a treatment clinic, we are an ECT training provider and a centre of research associated with the University of NSW.

In this video, Wesley Hospital Kogarah’s Medical Director of ECT, Professor Colleen Loo, explains the facts about ECT and how we use it.

Our team
Professor Colleen Loo is the Medical Director of ECT at Wesley Hospital Kogarah. She is an active clinician and researcher, and is joined in the department by Dr Brett Simpson and Dr Jenny McGoldrick, who each have more than 10 years of experience and are highly regarded as ECT psychiatrists.

The ECT Clinic
The Wesley Hospital Kogarah ECT clinic provides second opinions on ECT and advice on ECT treatments. To make an appointment, you will need a referral from a medical practitioner, or you can contact the ECT co-ordinator.

Here is what some of our patients have said about their ECT treatment:

“This will be my third treatment of ECT and I have been happy with the results”

“The treatment is good and recovery is well-administered. I would recommend the treatment”

“(ECT) helps stop voices, helps me carry on with work & enjoy family”

“Treatment was quite gentle and painless”

The facts about ECT

What is electroconvulsive therapy?
Electroconvulsive therapy (ECT) is a safe, effective medical treatment for severe psychiatric disorders, including clinical depression, mania and psychosis. It involves passing a brief, carefully controlled electrical current through the brain to affect the brain’s electrical activity, and aims to improve severe depressive and psychotic symptoms.

When is ECT prescribed?
ECT is most commonly used to treat severe depression, particularly in cases where the depression is so severe it has not been helped through medication, the person has experienced side effects from medication, or the person’s illness has become life threatening.

If you are not sure why you are being treated with ECT, don’t be afraid to ask. We know it is sometimes difficult to remember things when you are depressed, so you may need to ask several times.

How does ECT work?
Mental illness can disrupt the complex electrical and chemical processes that drive our brain function. Research shows that ECT can improve how these processes operate by changing the activity levels of different parts of the brain, releasing hormones and changing the brain’s signalling.

The latest research suggests ECT may even help the brain grow new brain cell tissue, meaning ECT could provide a way for the brain to repair the impaired brain circuits that may be responsible for depression.

How is ECT given?
ECT is usually given two or three times a week. The number of treatments needed will be different from person to person, but a typical course involves six to 12 treatments. Some people may need more treatments.

Is there evidence that ECT works?
To ensure high quality service, Wesley Hospital Kogarah’s ECT team monitors both the effectiveness and the side effects of the ECT treatments we deliver.

Our research and feedback from our psychiatrists show that ECT has proven to be an effective treatment for the patients in our care. In particular, our psychiatrists and patients reported that ECT helped patients improve their physical health, social relationships and work capabilities. Patients also said they did not experience any significant side effects, compared to their state of health before being treated with ECT.

We have analysed data from more than 800 ECT sessions given at Wesley Hospital Kogarah over a period of four years, and have found:

  • ECT treatments have been highly effective: 80% of our ECT patients were rated as ‘markedly ill’ before their ECT treatment began. After treatment, more than 83% of the patients were rated as ‘much improved’.
  • ECT had no significant effect on cognitive function: Nurses conducted a global cognitive dysfunction test (thinking and memory) and found no significant change in patients before and after their ECT treatment.
  • ECT improved patients’ quality of life: quality of life scores (rated by patients themselves, before and after ECT) showed an improvement of 37% after ECT. This includes ratings of improved mental state, physical health, social relationships and work capabilities.

How to prepare for ECT
If you are being treated with ECT, you should wear loose clothes or nightclothes. You will be asked to remove any jewellery, hair accessories or false teeth if you have them.

The treatment only takes a few minutes and other patients will not be able to see you having it.

The anaesthetist will give you an anaesthetic injection and some oxygen to breathe as you go to sleep. Once you are fast asleep, a small electric current is passed across your head, causing a mild seizure in the brain. You will move very little, though, because the anaesthetic will have relaxed your muscles completely. When you wake up, you will be in the recovery area, where you will be offered tea or coffee and some toast.

What are the side effects?
Like with many medical treatments, some people may experience side effects from ECT. Some patients may be confused just after they wake up from the treatment, but this generally clears up within an hour or so. People also experience some memory loss. Memories of recent events (particularly those that occur during the course of ECT) may be upset and dates, names of friends, public events, addresses and telephone numbers may be temporarily forgotten. In most cases this memory loss goes away within a few days or weeks, although sometimes patients continue to experience memory problems for several months. Uncommonly, there may be permanent loss of isolated memories.

Are there any serious risks from the treatment?
ECT is amongst the safest medical treatments given under general anaesthesia. The risk of death or serious injury with ECT is rare and comparable to that of any procedure involving an anaesthetic: less than one in 50,000 treatments. This is much lower than that reported for childbirth.

Very rarely, deaths do occur and these are usually because of heart problems. If you do have heart disease, it may still be possible for you to have ECT safely with special precautions such as heart monitoring. Your doctor will ask another specialist to advise if there are grounds for concern.

Are there any risks in choosing not to have ECT if it has been recommended?
If you choose not to accept our doctor’s recommendation to have ECT, you may experience a longer and more severe period of illness and disability than might otherwise have been the case. The alternative is drug therapy, which also has risks and complications. Drug treatment is not necessarily safer than ECT.

Giving consent to have ECT
We will not treat you with ECT without your consent. Before the treatment, your doctor will ask you to sign a consent form for ECT, agreeing to have up to a certain number of treatments.

Before you sign the form, your doctor will explain what the treatment involves and why you are having it, and will answer any questions you have about the treatment.

You can refuse to have ECT and you can withdraw your consent at any time, even before your first treatment. The consent form is not a legal document and does not commit you to have the treatment. It is a record that an explanation has been given to you and that you understand to your satisfaction what is going to happen to you. Withdrawing your consent to ECT does not in any way alter your right to continued treatment with the best alternative methods available.