Electroconvulsive Therapy (ECT): How It Works, What to Expect, and Side Effects
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What is electroconvulsive therapy?
Electroconvulsive therapy (ECT) is a medical treatment that uses a small electrical stimulus to trigger a brief, controlled seizure while you are asleep under general anesthesia. It treats severe depression, bipolar disorder, catatonia and schizophrenia, often when other treatments have not worked. It is given as a course, usually two to three times a week. [1]
What the research says
ECT outperforms both sham treatment and antidepressant medicines in the short term. A meta-analysis of randomized trials found real ECT worked significantly better than simulated ECT (6 trials, 256 patients) and better than drug therapy (18 trials, 1,144 participants) for depression. (UK ECT Review Group, Lancet, 2003) [2]
Memory dips during a course of ECT tend to recover afterward. In a 403-patient randomized trial of treatment-resistant depression without psychosis, 41.2% of people responded to ECT; memory recall dropped after 3 weeks of ECT, then gradually recovered during follow-up. (Anand et al., N Engl J Med, 2023) [3]
Serious heart events and death after ECT are uncommon. Pooling 82 studies (106,569 patients; 786,995 treatments), researchers found major cardiac events in about 1 in 50 patients and all-cause death in 0.06 per 1,000 treatments. (Duma et al., Anesthesiology, 2019) [4]
Key takeaways
ECT is the most effective treatment for severe depression and can work faster than other treatments. [1]
You are fully asleep and feel no pain; the seizure itself usually lasts 30 to 60 seconds. [1]
ECT is a course of treatments, typically two to three sessions per week. [1]
Common side effects are headache, muscle aches, nausea and a short rise in blood pressure. [1]
Memory problems are usually temporary and improve within a few weeks. [1]
How does electroconvulsive therapy (ECT) work?
Electroconvulsive therapy (ECT) works by applying a small electrical stimulus to the brain to cause a brief, controlled seizure while you are under general anesthesia. [1]
Experts are not completely sure why this helps. The leading theory is that ECT encourages brain cells to grow and form new connections, a process called neurogenesis. This may help reverse brain changes caused by depression and other mental health conditions. [1]
ECT is not new. Doctors began using it in 1938, and the procedure has improved a great deal over the decades. [1]
What conditions does electroconvulsive therapy (ECT) treat?
Electroconvulsive therapy (ECT) treats severe mental health conditions that do not respond well to medicines or other treatments. [1]
Condition | Learn more |
Major depressive disorder | |
Bipolar disorder | |
Mania | |
Catatonia | |
Schizoaffective disorder | |
Schizophrenia | — |
Neuroleptic malignant syndrome |
Source: [1]
For a wider view of how these illnesses fit together, see our guide to mood disorders.
Who is a good candidate for electroconvulsive therapy (ECT)?
A good candidate for electroconvulsive therapy (ECT) is someone with a severe mental health condition who also meets at least one of these situations: [1]
You are at risk of hurting yourself or others.
You are pregnant or breastfeeding.
You did not respond well to antidepressants or other medicines.
Your symptoms stop you from eating or getting through your daily routine.
ECT can be used safely during pregnancy with close monitoring. [1] If you are pregnant and struggling with low mood, our guide to prenatal depression may also help.
How do you prepare for electroconvulsive therapy (ECT)?
You prepare for electroconvulsive therapy (ECT) by following your care team's instructions, which usually include fasting beforehand. [1]
Fast: Do not eat or drink for at least eight hours before treatment.
Morning medicines: Take them with small sips of water only if your doctor says it is OK.
Dentures: Bring a case for dentures or partials.
Jewelry: Do not wear earrings, and remove facial piercings if you can.
Source: [1]
What happens during an electroconvulsive therapy (ECT) session?
During an electroconvulsive therapy (ECT) session, you are put to sleep with anesthesia, and electrodes deliver a small current that triggers a seizure lasting 30 to 60 seconds. [1]
Here is the usual order of events: [1]
Check in at the hospital registration desk and go to the treatment area.
A nurse places an IV line in a vein so you can receive medicine.
You meet the psychiatry and anesthesia teams.
You receive general anesthesia through the IV to fall asleep and relax your muscles. You may get other medicines too, which your team will explain.
You breathe oxygen through a mask while asleep, and your vital signs are closely monitored.
Electrodes deliver a small electrical current that triggers a seizure, usually lasting 30 to 60 seconds.
What happens after an electroconvulsive therapy (ECT) session?
After an electroconvulsive therapy (ECT) session, you start to wake up in about five minutes and stay in the treatment area for 30 to 45 minutes before going home. [1]
Time after treatment | What to expect |
About 5 minutes | You begin to wake up |
20 to 30 minutes | Grogginess or confusion usually fades |
30 to 45 minutes | You can go home once it is safe |
Whole visit | Plan for at least 2 hours, from check-in to discharge |
Source: [1]
What safety rules apply after electroconvulsive therapy (ECT)?
The main safety rules after electroconvulsive therapy (ECT) are no driving during your course and having a responsible adult with you for 24 hours after each treatment. [1]
Situation | Driving rule |
During an acute course (2 to 3 treatments per week) | Do not drive. Your outpatient provider must clear you before you drive again after the series ends. |
Maintenance ECT (1 treatment per week or fewer) | You may drive 24 hours after treatment, but only after getting clearance. |
Source: [1]
On every treatment day: [1]
Avoid heavy machinery and important decisions.
Plan ahead for childcare.
Have a responsible adult drive you to and from treatment. A taxi or ride-share service is not allowed for the trip home.
Make sure someone stays with you for 24 hours.
How often is electroconvulsive therapy (ECT) given?
Electroconvulsive therapy (ECT) is usually given two to three times a week as a course of treatments, not as a one-time procedure. [1]
The total number of sessions depends on your condition, how the ECT is done and how well you respond. Some people need repeat or ongoing treatments to keep the benefits. [1]
What are the side effects of electroconvulsive therapy (ECT)?
The most common side effects of electroconvulsive therapy (ECT) are headache, muscle aches, nausea and a temporary rise in blood pressure. [1] Your care team can give you medicines to reduce or prevent these. [1]
Common side effects | Rare or serious side effects |
Headache | Memory loss |
Muscle aches | Heart rhythm problems |
Nausea | Death (extremely rare) |
Temporary rise in blood pressure |
Source: [1]
Does electroconvulsive therapy (ECT) cause memory loss?
Electroconvulsive therapy (ECT) can cause memory problems, but they are usually worst right after treatment and improve over time. [1]
You may have trouble remembering events from the weeks or months before treatment started. This usually gets better within a few weeks. In rare cases it lasts longer, and permanent memory loss has been reported very rarely. [1]
What are the benefits of electroconvulsive therapy (ECT)?
The main benefit of electroconvulsive therapy (ECT) is relief from severe symptoms when medicines or talk therapy have not worked. [1]
It often works faster than other treatments, which matters in emergencies.
It may be an option if you cannot take certain medicines.
It can be used safely during pregnancy with close monitoring.
It is often combined with medicine to make treatment more effective.
Source: [1]
Does electroconvulsive therapy (ECT) work?
Electroconvulsive therapy (ECT) is an effective treatment for depression, catatonia, psychosis and other mental health conditions. [1]
Results can appear quickly and may last for a few years. You may need repeat treatments to maintain the effects. [1]
Is electroconvulsive therapy (ECT) like what you see in movies?
Electroconvulsive therapy (ECT) today looks very different from movie and TV scenes, which are often inaccurate and sensational. [1]
Screen portrayals rarely show the anesthesia or the careful safety steps used in real treatment. In practice, ECT is a closely monitored medical procedure, and your care team stays with you throughout. If you feel unsure, ask questions — that is exactly what your team is there for. [1]
When should you call a doctor after electroconvulsive therapy (ECT)?
You should call your provider or go to the nearest emergency room after electroconvulsive therapy (ECT) if you notice any of these: [1]
A fast or irregular heartbeat
Any concern about your mood or mental health
A severe headache
No improvement after two to three days, or feeling worse
Get emergency help now if you have thoughts of harming yourself or others. Call your local emergency number. In the U.S., you can call or text 988, the Suicide & Crisis Lifeline, available 24/7. [1]
Conclusion
Electroconvulsive therapy is a well-monitored, fast-acting treatment for severe mental illness — especially depression that has not responded to medicine. You are asleep throughout, the seizure lasts under a minute, and most side effects fade quickly. Memory changes are the side effect to discuss most carefully with your team, but they usually improve within weeks. [1]
If you or someone you love is considering ECT, bring this guide to your next appointment and use the FAQ below as a checklist of questions for your psychiatrist.
Keep learning: Explore our guides to clinical depression, bipolar disorder and catatonia to understand the conditions ECT treats.
FAQ
Is electroconvulsive therapy painful?
No. Electroconvulsive therapy is done under general anesthesia, so you are asleep and do not feel any pain or discomfort during the procedure. [1]
How long does an ECT session take?
The seizure itself usually lasts 30 to 60 seconds. With check-in, preparation and recovery, plan to spend at least two hours at each visit. [1]
How many ECT sessions will I need?
ECT is given as a course, usually two to three times a week. The total number depends on your condition, how ECT is done and how well you respond. [1]
Does ECT cause permanent memory loss?
Permanent memory loss after ECT is very rare. Memory problems are usually worst right after treatment and improve within a few weeks, though in rare cases they last longer. [1]
Can you have ECT while pregnant?
Yes. ECT can be used safely during pregnancy with close monitoring, and being pregnant or breastfeeding is one reason doctors may consider it. [1]
Can I drive after ECT?
You should not drive during an acute course of ECT. After the series ends, or on maintenance ECT, you need clearance from your provider before driving again. [1]
How fast does ECT work for depression?
ECT often works faster than other treatments, which is why it helps in emergencies. Results can appear quickly and may last for a few years. [1]
When should I seek emergency care after ECT?
Seek emergency care right away if you have thoughts of harming yourself or others. Also call your provider for a fast or irregular heartbeat, a severe headache or worsening mood. [1]
Is electroconvulsive therapy safe?
Yes, for most people ECT is considered a safe treatment. It is done under general anesthesia while a care team watches your heart, breathing and oxygen the whole time. Your team checks your health beforehand to lower the risks.
What side effects are common right after an ECT session?
Headache, muscle aches, nausea and feeling confused or groggy are common right after a session. These effects usually fade within a few hours. Tell your care team if they are severe or do not go away.
Related Reading
What Is Clinical Depression (Major Depressive Disorder)? Symptoms, Causes, Diagnosis and Treatment explains the symptoms, causes and treatments of major depression.
Transcranial Magnetic Stimulation (TMS): How It Works, Who It Helps, and What to Expect describes how magnetic brain stimulation treats depression without anesthesia.
Catatonia: Symptoms, Causes, and the Highly Effective Treatments covers catatonia signs and why ECT is a key treatment.
Ketamine Therapy: Uses, How It Works and Side Effects explains how ketamine treatment works for hard-to-treat depression.
References
Cleveland Clinic. Electroconvulsive Therapy (ECT): What It Is & Side Effects. Cleveland Clinic. Last updated May 26, 2025. https://my.clevelandclinic.org/health/treatments/9302-ect-electroconvulsive-therapy
UK ECT Review Group. Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet. 2003;361(9360):799-808. PMID: 12642045. https://doi.org/10.1016/S0140-6736(03)12705-5
Anand A, Mathew SJ, Sanacora G, et al. Ketamine versus ECT for Nonpsychotic Treatment-Resistant Major Depression. N Engl J Med. 2023;388(25):2315-2325. PMID: 37224232. https://doi.org/10.1056/NEJMoa2302399
Duma A, Maleczek M, Panjikaran B, et al. Major Adverse Cardiac Events and Mortality Associated with Electroconvulsive Therapy: A Systematic Review and Meta-analysis. Anesthesiology. 2019;130(1):83-91. PMID: 30557212. https://doi.org/10.1097/ALN.0000000000002488
Medical disclaimer
This article is for general education and does not replace professional medical advice, diagnosis or treatment. Always talk with a qualified healthcare provider about your own symptoms and treatment options. If you are in crisis or thinking about harming yourself, contact your local emergency number right away.
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