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What Are the Pros and Cons of Electroconvulsive Therapy for Bipolar?

By Alicia Sparks
Updated May 17, 2024
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Electroconvulsive therapy (ECT) for bipolar disorder can present pros such as managing otherwise treatment-resistant symptoms, providing relief for patients who cannot take oral medications, and allowing patients to undergo less frequent treatments. On the other hand, ECT can present cons like physical and mental side effects such as nausea and memory loss. Often, patients who have other psychiatric treatment options might choose to avoid ECT, whereas those who are ideal candidates for ECT might choose to endure the side effects.

Perhaps one of the most significant pros of using electroconvulsive therapy for bipolar disorder is that it sometimes provides relief from symptoms that other treatment options failed to manage. For example, if certain bipolar disorder symptoms like severe depression or mania prove to be treatment-resistant, ECT might help. Generally, patients and their doctors will not begin considering ECT until other treatment options have been tried and proven ineffective.

Sometimes, electroshock is the only psychiatric treatment available. Certain patients, such as pregnant or nursing women and individuals who cannot tolerate medication side effects, might turn to electroconvulsive therapy for bipolar disorder treatment. The length of the ECT treatment, and whether the patient resumes oral medications once they are able, depends on the patient’s personal situation and the doctor’s recommendation.

Also, ECT can be done less frequently than a patient would have to take oral medications for bipolar disorder. Typically, a patient with bipolar disorder takes at least one oral medication a day, sometimes multiple times a day. Depending on the severity of his symptoms, he may take more than one medication. This can become confusing for some patients. On the other hand, an entire ECT procedure usually takes around 15 minutes, three times a week for up to four weeks.

Most of the cons associated with using electroconvulsive therapy for bipolar disorder are related to the side effects. Many ECT side effects are similar to the kinds of side effects other treatment options, like oral medications, present. Patients may experience mental side effects, such as temporary confusion and memory loss. Physical side effects such as muscle spasms and pains, headaches, and nausea and vomiting can occur, too. Since general anesthesia is involved, certain risks like a significant increase in heart rate and blood pressure might occur.

Other cons are related to the stigma of electroshock, and that stigma extends to mental illness in general. Since being introduced in 1938, electroshock therapy as a medical treatment for mental illness has undergone significant advances. Still, some people view ECT as dangerous, and a drastic measure only severely ill people need. This stigma can prevent qualified patients from seeking or undergoing electroconvulsive therapy for bipolar disorder. If the patient is not undergoing any other kind of psychiatric treatment, or is not experiencing relief with another treatment, avoiding ECT could prove dangerous.

In the end, each patient and his doctor will discuss the pros and cons of electroconvulsive therapy for bipolar disorder. Some might determine ECT could be an effective psychiatric treatment, and others might pursue alternative treatment options. Similar to other kinds of bipolar disorder treatment options, ECT might be used for a specific amount of time and then re-evaluated based on the results.

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