William McDonald, M.D., Associate Professor of Psychiatry, The Emory Clinic
Question: What kinds of depression are best treated by electroconvulsive therapy (ECT)?
Answer: The types of patients who come to ECT are patients who are medication resistant -- that is, patients who've tried multiple antidepressants and haven't had any real lasting effect in their treatment. These patients may have had a partial effect or no effect at all. Patients who come to ECT have often failed four or five different medication trials.
The other types of patients that come to ECT are patients who are very ill and need a quick and immediate treatment. That is patients who are so suicidal --so psychotic -- who are not eating and not sleeping and need to be treated quickly. ECT, unlike the medications, can work in a matter of a couple of weeks -- one to two weeks -- where as medications can take six to 10 weeks to really have a full effect. So ECT is used in treatment resistant depression as well as patients with very severe depression.
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