Electroconvulsive Therapy (ECT)
UVA is the major provider of electroconvulsive therapy services in the central Virginia area. Patients come to UVA from throughout the state (and even out of state), including as far as Lexington, Winchester, Harrisonburg, Fredericksburg, Williamsburg, and Virginia Beach. The majority of treatments are provided on an outpatient basis, although patients who do require inpatient psychiatric care also can receive ECT while on our inpatient unit. UVA also provides ECT services to patients from Western State Hospital in Staunton, Virginia.
ECT requires more complex clinical services since: (1) Patients who receive ECT tend to have more severe psychiatric symptoms; (2) These patients tend to be taking several medications in addition to receiving ECT; (3) Services must be coordinated with the patient’s local psychiatrist; (4) Patients must be continually monitored for safety and provided with education and advice not only for their psychiatric illness but from the potential side-effects of ECT (e.g., monitoring for driving safety and ability to function in the community) and family members and/or friends typically also need to be involved in these discussions.
UVA psychiatry residents rotate through this service and receive supervision and didactics specific to the practice of ECT. ECT competency is required for graduation.
The number of recommended treatments is tailored to the individual patient’s needs. During an acute course of therapy, patients typically receive 2 to 3 treatments per week and typically receive between 6 to 12 treatments during the entire course of therapy. Patients who have responded well to ECT have the option of receiving further maintenance sessions (one session every few weeks) in addition to their usual psychiatric treatment (medications and/or psychotherapy) to provide additional benefit in preventing a relapse of symptoms.
ECT has been safely performed for patients who are medically frail, are elderly, are pregnant, or have had difficulty tolerating various psychiatric medications. The most common post-treatment side effects are headache, muscle aches, and nausea. If these side effects do occur, they can be addressed with medications administered either during or after the procedure. Some people experience short-term memory loss during the course of treatment. This usually improves following completion of the acute course of treatment, although rarely some patients do experience memory problems for a longer period of time. The treating psychiatrist discusses potential side effects with patients in greater detail during the initially consultation and throughout the course of therapy. Because of the potential for impaired concentration and memory, patients should refrain from driving or making important personal or business decisions during or immediately after the ECT course or on the day of a maintenance ECT therapy session.
The ECT Service is directed by Bruce Cohen, M.D. To schedule an ECT consultation, prospective patients should have their treating psychiatrist contact Dr. Cohen at 434-924-2241 and should fax clinical information to 434-924-8496.