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Electroconvulsive therapy (ECT)

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Electroconvulsive therapy (ECT) is a medical treatment for severe depression, mania and schizophrenia.

ECT uses a small electrical current to briefly stimulate the brain. It’s performed under anaesthetic in a hospital. Evidence shows that ECT clears symptoms of depression and other mental illnesses.

ECT is safe, painless and effective in treating depression.

Over 7500 Australians and 300 New Zealanders have electroconvulsive therapy each year.

Why is ECT used?

Psychiatrists use ECT because:

  • It works. ECT can improve or clear depression in nearly 70% of patients, and has been proven to help with other conditions such as mania and schizophrenia.
  • It works quickly. ECT can be a life-saving treatment for people who are at risk of suicide, or who are not eating or drinking because of their depression.
  • It’s safe and there are few side effects.
  • It provides another treatment option if medication is not working or if a patient has bad reactions to their medication.
Many people who have depression will respond to a talking therapy. Many will respond to medication. ECT can be recommended when other treatments don’t provide adequate benefit. It is also recommended when any delay in improvement or recovery could be life threatening or damaging.

Dr Bradley Ng, psychiatrist

Where do you get ECT?

ECT is provided in private and public hospitals in Australia.

In New Zealand, all ECT is provided by the District Health Boards. 

You may be an inpatient (where you are admitted to hospital for the night) or you may also have the procedure as an outpatient (where you can go home the same day).

What happens during ECT?

You will be put to sleep with a general anaesthetic and be given a medicine that relaxes your muscles.

When asleep, your psychiatrist will place two electrodes on your head and deliver a short electrical pulse that will induce a small seizure. You are asleep for 3-5 minutes and the seizure lasts 20-60 seconds. You will be asleep and unaware during the treatment.

You will then be moved to the recovery ward to wake up from the anaesthetic. The whole procedure takes around 20 to 30 minutes and if you are an outpatient at the hospital you will be able to go home the same day.

On average around 8-12 sessions of ECT are given in a treatment course, with a few days between sessions. You may need more or fewer sessions depending on your condition.

Who can give ECT?

Only approved psychiatrists with special training should give ECT.

All psychiatrists in Australia and New Zealand follow strict regulations to ensure that ECT is performed safely. These regulations are contained in state Mental Health Acts and guidelines issued by Chief Psychiatrists and Health Departments.

How does ECT work?

The small electrical current increases the level of electrical activity in the brain leading to seizure. Current scientific evidence suggests that the seizure may rebalance the chemicals in the brain that cause depression and other mental illnesses.

Is ECT safe?

ECT is a very safe treatment.

The risks are similar to any minor medical procedure given under general anaesthetic.

Will ECT cure depression?

Around 60-70% of people who have ECT for depression say their symptoms clear completely. Up to 80% say they get some benefit.

However, there is a high chance that depression will come back in the weeks or months after a course of ECT. 

Follow up medication, psychological treatment (talking therapy) and help for dealing with stress are essential in staying well.

I had 12 sessions of ECT. My husband says that he noticed a difference in me after about the fifth one. The difference is I feel normal again. I can get out and do my volunteer work. Before I went and had it I was so sick. I couldn’t talk, I was really bad. I know that I wouldn’t be where I am now if I hadn’t had the ECT.

Carolyn, ECT patient, Gold Coast

The depression can come back but knowing that there is something I can do to treat it makes the next episode less stressful.

Vivienne, ECT patient, Melbourne

What are the side effects of ECT?

The main side effect of ECT is memory loss.

Short-term memory loss

A small number of people who have ECT can’t remember what happened on the morning of treatment or the day before or have patchy memories of the time. Some have trouble remembering or concentrating for the day after the treatment. However, depression alone can cause the same symptoms.

This type of memory problem will go away after the course of ECT is finished. You should expect to be fully recovered in 2-4 weeks.

Long-term memory loss

In much rarer cases, patients report that they have no memory of certain events in their past.

Research into ECT is trying to find ways to reduce these side effects further.

I've had severe depression for 16 years. Any short-term memories I lose to get rid of that never-ending, crushing feeling of hopelessness and sadness are worth it, in my opinion.

Adrian, ECT patient

Myths and fears about ECT

If you are worried about getting ECT, it’s important to talk about how you are feeling with your psychiatrist.

Below are some common questions psychiatrists are asked about ECT:

Will I get brain damage?
Does ECT hurt?
I'm scared about getting ECT
Can someone be given ECT if they don't want it?

Useful links

Remember

  • Electroconvulsive therapy (ECT) is safe and can clear symptoms of depression and other mental illnesses.
  • Some people get side effects from ECT, including short-term memory loss.
  • If you are worried about treatment, make a list of your concerns.
  • Your psychiatrist will be happy to answer any questions you may have.
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Page last reviewed Jan 2020 | C1005V1

This is a general guide only, and does not replace individual medical advice. Please speak to your doctor for advice about your situation. The RANZCP is not liable for any consequences arising from relying on this information. Subject matter experts, people with lived experience of mental illness and carers all contributed to this fact sheet.