The Cognitive Side Effects of ECT...

My biggest concern when I was trying to decide whether to do ECT was whether I would hurt my brain.  There's actually evidence to suggest that ECT might lead to brain "re-growth" in areas that may be atrophied in patients with chronic, severe depression!  But that doesn't mean there's not some scary cognitive issues that occur when one is doing ECT!  However, depression in and of itself has affected my memory and cognitive functioning, so it can be a bit tricky to try to distinguish what is depression, what is ECT and what is something else entirely!

Short term memory problems have become an issue for me as I've gone through ECT, and as is not uncommon, it is getting more severe as I have more and more treatments.  Most of it is unimportant stuff - not remembering what I had for dinner last night or not remembering what treatment number this week will be.  Sometimes it's a really weird experience, like last week when I didn't even realize I had already had my ECT treatment.  I thought I was waiting to go in for my treatment and I was already done.  That was really bizarre! I also had absolutely no recollection of seeing the doctor that had done the ECT.  It was a bit unnerving but I'm reassured that it's completely normal. 

Because of the anesthesia required for ECT, I will always need Kyle or a friend or family member to drive me to and from an ECT treatment.  But in this acute phase of treatment where the doctors and I are monitoring the effect that the ECT has on me and my body, I have not been permitted to drive at all.  I was finally cleared to drive on none ECT days this past Friday.  

There's some cognitive dysfunction right after the procedure - that's the most common.  That's the sort of disorientation most of us experience when we are coming out of anesthesia.  This generally resolves within minutes to hours after having ECT.  I'm starting to experience a lot more of this in the later treatments than I did early on.   

My psychiatrist started me on the medication donepezil, which is a cholinesterase inhibitor used to treat dementia (eg, impairment of memory, judgment, and abstract thinking; changes in personality) in patients with Alzheimer's disease (or those doing ECT, apparently!)  

In the beginning of ECT, during the acute phase, ECT is administered three times a week on Monday, Wednesday and Friday.  Into my third week Dr. F. reduced my treatments to twice a week and then just once a week because I was having too many cognitive side effects.  The treatment team uses a variety of indicators to tell them how we're doing.  This past week my depression score was getting too high again, so Dr. F. told me it may be necessary to go back to two ECT treatments a week temporarily to get the depression under control again.  It's a challenging balance to try to figure it all out!

If you have any questions about ECT please ask them.  I will do my best to answer them or find someone who can answer them!