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Electroconvulsive Therapy (ECT) Service

ECT is a safe and effective treatment that involves passing a carefully controlled electrical current through a person’s brain to trigger a seizure — a rapid discharge of nerve impulses throughout the brain. In recent years, the National Institute of Mental Health, the American Psychiatric Association, and the U.S. Surgeon General all endorse ECT as a valuable tool in the treatment of certain psychiatric disorders, and major depression in particular. Each year hundreds of patients are treated with electroconvulsive therapy (ECT) in the Department of Psychiatry and Behavioral Sciences. This procedure can be done on an inpatient or outpatient basis.

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AskHopkinsPsychiatry Q&A Video

Dr. Irving Reti answers the question:
Is ECT still considered a treatment for depression and are there reasons you would have it instead of taking medication?
Dr. Reti on video

Johns Hopkins now provides ECT treatment with ultra-brief pulses to reduce cognitive side-effects. Recent studies demonstrate that ECT delivered with ultra-brief pulses produces less memory loss and other cognitive side-effects than ECT delivered with standard pulses. Historically, ECT has been administered with pulses that are one millisecond in width whereas recent studies have delivered ECT with pulses in the range of 0.25-0.37 milliseconds, which also triggers a seizure but more efficiently and with fewer cognitive side effects.

A recent study comparing the two modes of stimulus delivery: In this study, patients receiving ultra-brief pulses not only had fewer side effects but responded to the treatment just as well and as quickly as patients receiving standard pulses.Sackeim H, et al. (2008). Effects of pulse width and electrode placement on the efficacy and cognitive effects of electroconvulsive therapy. Brain Stimul,1(2):71-83.

Another study by other researchers also showed ultra-brief pulses produced less cognitive side effects as well as similar rates of efficacy. However, in the latter study patients on average required more treatments to get well with ultra-brief pulses.Loo CK, Sainsbury K, Sheehan P, Lyndon B. (2008). A comparison of RUL ultrabrief pulse (0.3 ms) ECT and standard RUL ECT. Int J Neuropsychopharmacol,11(7):883-90.

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Dr. Irving Reti

TMS is still on track for deep depression


Electroconvulsive Therapy Today,
An in-depth article from the Johns Hopkins Depression and Anxiety Bulletin.

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