Electroconvulsive therapy (ECT)

Electroconvulsive therapy (ECT) is a treatment for serious mental health conditions. It may be used to help improve your symptoms if other treatments have not worked. ECT is sometimes called ‘electric shock treatment’, but this term is not commonly used by healthcare professionals.

ECT involves sending a small electric current to your brain, which causes a seizure. You will first have a general anaesthetic so you will not feel the procedure.

It is not fully understood how ECT works, but it is thought to act by affecting the levels of different chemicals in the brain.

ECT is a very effective treatment for a range of mental health problems, and it works quickly. Sometimes people do not want to have ECT because of problems with how it was used many years ago. For this reason, and because it can affect memory, it is not used as widely as some other mental health treatments. Your doctor is likely to recommend other treatments first, before suggesting ECT.

ECT can be used to treat:

• severe depression
• psychosis
• repeated, severe self-harming behaviours in people with autism spectrum disorder
• bipolar disorder
• schizophrenia

ECT may be used when other treatments have not worked. It might be considered after trying medicines, such as antidepressant medicines and psychotherapy (talking therapies).

ECT usually works faster than other treatments. This makes it a good option when you need quicker results, for example if there is a high risk of suicide.

ECT is only available in approved hospitals or mental health facilities.

During each treatment, 2 doctors must be present. One doctor must be a psychiatrist who has experience in ECT. The other is an anaesthetist who gives the general anaesthetic before the ECT procedure. This means you will not feel pain or be aware of what is happening during the procedure. A nurse is also there to make sure you are well cared for.

Electrodes are placed on one or both sides of your head. These are used to send a small electric current, which triggers a brief seizure.

The procedure usually takes up to 20 minutes. A full treatment course involves 6 to 12 sessions. You will usually have 2 to 3 sessions a week. 

Informed consent

Before starting ECT, you must give informed consent. This means you understand the treatment, including the risks and benefits. You have the right to withdraw (stop) your consent at any time during the treatment.

Sometimes, you may be too unwell to give consent, or you may have been ordered to have treatment without your consent (Opens in new tab) based on the law in your state or territory. If this is the case, your psychiatrist will follow local and national laws to make sure you are safe.

Before having ECT, you may need to have:

• blood tests 
• an electrocardiogram (ECG)
• an x-ray of your chest
• a scan of your brain

You will be asked not to eat or drink for up to 6 hours before each ECT session.

Ask your doctor if you should avoid taking any of your regular medicines before having ECT.

You will wake up a few minutes after the treatment is finished.

Read more about recovering from a general anaesthetic.

Like all treatments, ECT can have side effects. It can often cause memory loss and difficulty speaking fluently, remembering information, thinking or concentrating. This usually improves within 3 months after treatment. 

Other common side effects soon after ECT include:

• disorientation and confusion
• headaches
• nausea (feeling sick)
• sore muscles

Your healthcare team will explain what to expect after ECT, including how you may feel, any possible side effects and your recovery. They will also give you time to ask questions so you understand your treatment and what happens next. Be sure to ask about anything you do not understand or want to know more about.

After ECT

After ECT, your treatment plan will be regularly reviewed. To help prevent your symptoms coming back, you may need antidepressant or mood-stabilising medicines and psychotherapy. 

Sometimes, you may need more ECT sessions together with medicines.

ECT is considered a safe treatment with a low risk of serious complications.

Sometimes, ECT can cause long-term or permanent memory loss. 

It may also affect your thinking and your ability to drive, especially in the first month after treatment. This should be considered when making major life decisions after ECT or planning the timing of ECT.

Occasionally ECT can cause an abnormal heart rhythm or changes in blood pressure. 
Your anaesthetist will check if you are at risk and monitor you during the procedure.

As with any procedure, there is a very small chance of complications from the anaesthetic. The risk of heart attack, stroke or death from ECT is very low.

If ECT is given without an anaesthetic, it can cause fractures, dislocations or injuries to your teeth. This is not done in Australia.

There are some alternatives to ECT. Your healthcare team will help you consider these, based on your needs and how you respond to treatment.

Other treatment options may include:

• medicines — such as antidepressant medicines and mood stabilisers
• psychotherapy — such as cognitive behavioural therapy (CBT)
• repetitive transcranial magnetic stimulation (rTMS) — a treatment that uses magnetic fields to stimulate brain activity

Your doctor may prescribe ECT because you are very unwell and need a treatment that works quickly. You could be at risk of suicide if you do not have ECT or if it is delayed.

Your doctor will only suggest you have ECT if they think it is likely to help you. If you are worried about having ECT, ask your doctor about other options and why they think ECT is a good choice for you.

Read the healthdirect page on suicide warning signs.

If you need to talk to someone about your mental health, call Beyond Blue (Opens in new tab) on 1300 22 4636.

For more information about ECT, you can visit Black Dog Institute (Opens in new tab). 

Languages other than English

Visit Embrace Multicultural Mental Health (Opens in new tab) for mental health information and resources in many community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

Black Dog Institute (Opens in new tab) has support services for Aboriginal and/or Torres Strait Islander peoples.

13Yarn (Opens in new tab) has crisis support for Aboriginal and/or Torres Strait Islander peoples. It's a confidential culturally safe space to yarn about your worries or concerns.

Information for sexually and gender-diverse people

HERE (Opens in new tab) has information on suicide and connects people of diverse genders and sexualities and their loved ones.