Electroshock Therapy Gets a Makeover

July 20, 2007 — -- Amy, a New York resident, had her first electroshock treatment at the age of 72 … and despite the stigma that electroshock is a brutal, outdated procedure for treating psychiatric health, she said it's been a miracle for her.

And it's probably more common than most people believe.

"I started 10 years ago when I was very depressed. I was diagnosed as bipolar. I took medicine -- Prozac, a whole slew of them -- but they didn't help," she said. "Then a psychiatrist told one of my friends that I should have ECT. My friends told me to get ECT. It was the only solution, I couldn't go on the way I was. After ECT, everyone told me it was a miracle."

Amy, who asked that her last name not be used, is now 82 and continues to receive electroshock therapy regularly.

Although she admits that after each procedure she has a headache and her memory is temporarily "a little bit off," she insists that ECT has been a success for her.

"I know there's a lot of negative. I think it's a rather painless procedure. It's wonderful," she said. "If medicine doesn't work, then yes, I would recommend it to someone else."

Since its terrifying depiction in the movie "One Flew Over the Cuckoo's Nest," electroshock, or electroconvulsive therapy (ECT) has changed dramatically. According to doctors who use it, the administration of the anesthetic, changes in the type of electricity used and the way seizures are triggered have transformed the procedure, making it safer and more effective.

The latest clinically available form of ECT, called ultrabrief pulse unilateral, uses a briefer stimulus that lasts for .25 to .3 milliseconds, according to Dr. Sarah Lisanby at the New York State Psychiatric Institute. The difference in the type of electricity used allows doctors to induce seizures with lower amounts of electricity then was previously possible.

"It does away with lifelong memory loss," said Dr. Harold Sackheim, a leading proponent of ECT and chief of the department of biological psychiatry at the New York State Psychiatric Institute. "If there is any memory loss, it's markedly reduced."

Although there are no national reporting requirements for the number of procedures performed, experts estimate that approximately 100,000 patients a year in the United States and several million worldwide receive ECT.

According to Dr. Mustafa Husain, the director of the Geriatric Psychiatry Training Program at the University of Texas Southwestern Medical Center, the newer version of ECT is becoming the standard in practice, particularly at academic medical centers and clinics due to its relatively low amount of adverse effects on the brain.

"We started the new ECT almost a year ago. All of our equipment is now ultrabrief pulse," he said.