Electroconvulsive Therapy Research Paper

During the 18th and 19th century, it became well known that chemicals such as camphor can induce seizures to help with mental illness.1 In 1934, a Hungarian psychiatrist, Ladislaw Meduna, empirically pursued his theory on the relationship between seizures and schizophrenia using camphor oil. He wanted to see if he could cure a patient with catatonic schizophrenia by inducing epilepsy in the patient through injecting the patient with the camphor oil. After several of these treatment sessions, the patient was reportedly in full recovery of the condition. Around 1938, an Italian scientist, Ugo Cerletti successfully attempted the use of electricity instead to induce a therapeutic seizure in a delusional patient. Once again, after several treatments it was reported that the patient had significant improvements of his condition and thus electroconvulsive therapy began.1,2 Today, electroconvulsive therapy is mainly used for the treatment of severe depressive disorders, especially major depressive disorder. 1,2 According to the Diagnostic and Statistical Manual of Mental Disorders 5,3 sufferers of major depressive disorder have experienced several symptoms of daily depressed mood, low interest and pleasure in activities, weight loss or gain, sleeping problems, slowness and fatigue, feelings of hopelessness and worthlessness, difficulty concentrating, and suicidal thoughts every day for at least a two week time period.
Approximately 14.8 million U.S.
adults suffer from major depression causing severe disabilities for the individuals.1 This paper will explore the clinical use of Electroconvulsive therapy for depression through identifying and understanding the possible therapeutic as well as adverse cognitive effects of the
procedure.

Electroconvulsive therapy (ECT) is a form of brain stimulation therapy where small electric currents are sent to the brain which induces a seizure.2 This is known to help treat the symptoms of severe mental illnesses. ECT is often used once other treatments such as antidepressant medication or psychological therapy have shown to not be successful.1 However, the therapeutical effects of ECT have been found to have the highest success rate of any treatment and this is mainly due to its rapid form of treatment.2 The mechanism for ECT and why it works for depression is yet to be known or fully understood. There have been many different theories proposed over the years, but there is still no precise theory due to the complexity of the nervous system.1 There has been a proposed hypothesis on the relationship between cortical connectivity and depression before and after ECT administration which will be discussed further along in the paper.

The main use of ECT is to treat severe depression. Therefore, it is for individuals who are severely depressed and medications are not sufficient or working. This is referred to as treatment-resistant depression.1,2 This also includes those who are contemplating suicide. Other uses for ECT include those who are suffering from catatonia which is difficulty in movement or having abnormal movements. Catatonia is usually associated with schizophrenia disorder Severe mania is another condition in which ECT can provide therapeutic help. Severe mania is associated with bipolar disorder and this consists of being in a state of high energy and euphoria and being hyperactive leading to very risky and impulsive decisions and behaviors.1,2,4,5 Additionally, elderly patients who have dementia often exhibit symptoms of aggression and agitation, thus ECT can be used to help reduce such burden.1,2,4 Lastly, ECT is often used for elderly patients with mental disorders due to their inability for tolerating drugs and the higher risk of side effects among the elderly.1,2,4 ECT may not help everyone, however, it can be successful for patients who stick to follow up treatments.4

The use of electricity to induce seizures as a form of therapy became the main form of biological treatment performed in the psychiatric field and administered in mostly mental institutions during the 1940s and 50s.1,2 However, at the time, the brain stimulation procedure was given in an unmodified form which means without any anesthesia or muscle relaxant and in higher doses. Unmodified electroconvulsive therapy lead to many adverse effects including fractures and dental injuries. Because of this, by the 1950s, ECT was performed in a modified form that included anesthesia, oxygen, and monitoring the heart rate. Also by the 1970s, the APA Task Force was formed to protect patients and have better practices of ECT.2 However, controversy surrounding electroconvulsive therapy intensified following the release of the 1975 film, One Flew Over the Cuckoo’s Nest, an adaptation of the book with