How ECT helps severely depressed

Aberdeen researchers have discovered how a controversial but effective treatment in psychiatry acts on the brain in people who are severely depressed.

Electroconvulsive therapy – ECT - which involves anaesthetising a patient and electrically inducing a seizure, is the most potent treatment option for patients with serious mood disorder.

Despite being used successfully in clinical practice around the world for more than 70 years, the underlying mechanisms of ECT have so far remained unclear.

Now a multidisciplinary team of clinicians and scientists at the University of Aberdeen has shown that ECT affects the way different parts of the brain involved in depression communicate’ with each other.

In a paper published in the journal Proceedings of the National Academy of Sciences they show that the treatment appears to ‘turn down’ an overactive connection between areas of the brain that control mood and the parts responsible for thinking and concentrating.

This stops the overwhelming impact that depression has on sufferers’ ability to enjoy life and carry out day to day activities.

This decrease in connectivity observed after ECT treatment was accompanied by a significant improvement in the patient’s depressive symptoms.

Professor Reid, Professor of Psychiatry at the University of Aberdeen and Consultant Psychiatrist at the city’s Royal Cornhill Hospital who led the study, said: “ECT is a controversial treatment, and one prominent criticism has been that it is not understood how it works and what it does to the brain. However we believe we’ve solved a 70 year old therapeutic riddle because our study reveals that ECT affects the way different parts of the brain involved in depression connect with one another. For all the debate surrounding ECT, it is one of the most effective treatments not just in psychiatry but in the whole of medicine, because 75 per cent to 85 per cent of patients recover from the symptoms.”