Harold Sackeim, M.D., Columbia University

I am about to go in for ECT for the first time and am wondering what to expect.

Most people have between 6 and 12 treatments over a period of about four weeks.  However, people differ in their speed of improvement and some need shorter or longer treatment courses.  Each treatment should last about 15 to 20 minutes.  It will also take some time for the anesthesia to wear off.  This only requires a few additional minutes.

It usually takes several treatments for individuals to begin to feel improvement and with each subsequent treatment the period of symptom relief lasts longer and the degree of improvement deepens.  Once all symptoms abate or maximal improvement has been achieved, ECT treatment is ended.  Often there is temporary limited memory loss during and following the treatment course, but memory functions usually return quickly.

I recently completed a successful treatment with ECT.  I am worried about having a relapse.  Should I take medication to prevent one?

After a successful course of ECT, most patients and doctors choose treatment with medications to prevent relapse, as opposed to continuing maintenance with ECT.  Many people are concerned about their depression returning.  Some people do have relapses even after responding to ECT.  Antidepressant medication may help prevent a relapse.  Discuss this option with your doctor.

If you have proven resistant to a medication, (i.e. taken a medication for at least eight weeks with no response or insufficient results when depressed), the chances are you will have a better outcome in relapse prevention with a different medication.  If a particular medication caused unacceptable side effects, it may do so again.  You should share this information with your doctor.  Make sure your doctor knows your medical history including medications you have been prescribed and their results.  It can save you both time and discomfort.