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Electro-Convulsive Therapy

Sacred Heart’s Psychiatry Department is the only provider of hospital-based electroconvulsive therapy (ECT) for the Inland Northwest. This service is available for both inpatients and outpatients and is supported by staff in the Adult and Geriatric Psychiatry Unit.

ECT is endorsed by the American Psychiatric Association as a safe and highly effective treatment for certain mental illnesses. While ECT is most commonly used to treat severe depression, particularly in cases where psychotherapy and medication have not been successful, it is also a valuable treatment for a wide variety of other psychiatric and neurological conditions.

At Sacred Heart, ECT treatment is provided by a team of board-certified adult psychiatrists credentialed in electroconvulsive treatment, with the assistance of anesthetists and registered nurses who have expertise in psychiatry and pre- and post-recovery care.

Clearing up misconceptions

Due to the way movies and media have portrayed electroconvulsive therapy or ECT, this vital treatment remains critically misunderstood. The truth is, ECT is a lifesaver for some people who suffer from acute depression and for whom medications simply are not effective.

Essentially, electroconvulsive therapy involves restructuring the brain’s neurochemistry by inducing a seizure. Once referred to for ECT, patients and their loved ones receive thorough education about what to expect. They watch videos, learn about the use of anesthesia and visit with an experienced psychiatry nurse to discuss any concerns. The procedure is handled the way many other hospital procedures are, with specific instructions, a review of medications, intravenous (IV) therapy and anesthesia. Patients are not restrained, there is no pain and the procedure is over in a matter of minutes.

Patients undergoing the treatment receive a medication to relax their muscles so the seizure does not affect their bodies, but is limited to brain activity only. The ECT nurse delivers the tiniest amount of electricity to the appropriate area of the brain; after just two to three seconds, the seizure is induced and the electricity is stopped. Then the brain carries out the seizure for about 20-40 seconds. All the while, a computer is mapping the length and intensity of the seizure. In three to four minutes, the anesthesia wears off and the patient begins to wake up and receives one-on-one care from a nurse. Patients are released to return home with a loved one within an hour and a half of their arrival.

"More than 70 percent of patients who use it experience a drastic improvement in their quality of life," says Saj Ravasia, MD, psychiatrist at Sacred Heart. And while it does have side effects such as short-term memory loss, he says, "Patients who need ECT definitely feel the benefits greatly outweigh the risks."

Over the years, Sacred Heart’s ECT team has seen hundreds of people get beyond their depression barrier. In 2005, they offered more than 1,300 treatments to approximately 150 patients who receive an average of 7-10 treatments each. Out of those 150, only about 15 patients return for “maintenance” treatments to keep them healthy. Patients are typically 55-70 years old, although the department has helped patients as young as 16 and as old as 99.

Psychiatric disorders

Major depression, bipolar depression, schizoaffective disorder, catatonic disorder, schizophrenia and other functional psychoses.

Indications for use

Where a need for rapid, definitive response exists.
When the risks of other treatments outweigh risks of ECT.
When history of poor drug response exists.
Patient preference.

Important information

Of the 1,200 cases per year, about 57 percent are outpatients.
Covered in part by Medicare/Medicaid.
Covered at least in part by most insurance carriers, after required preauthorization.
Referrals must be made by a physician

To make a referral for ECT, call the Psychiatry Admission Coordinator: (509) 474-4893.