This article is from the Depression FAQ, by Cynthia Frazier with numerous contributions by others.
The physician must fully explain the benefits and dangers of ECT, and the patient give consent, before ECT can be administered. The patient should be encouraged to ask questions about the procedure and should be told that consent for treatments can be withdrawn at any time, and in the event that this happens, the treatments will be stopped. After giving consent, the patient undergoes a complete physical examination, including a chest x-ray, electrocardiogram, and blood and urine tests. A series of ECTs usually consists of six to twelve treatments. Treatments can be administered to either in-patients or out-patients. Nothing should be taken by mouth for 8-hours prior to a treatment. An intravenous drip is started and through it medications to induce sleep, relax the muscles of the body, and reduce saliva are given. Once these medications are fully effective, an electrical stimulus is administered through electrodes to the head. The electrical stimulus produces brain wave (EEG) changes that are characteristic of a grand mal seizure. It is believed that this seizure activity leads to the clinical improvement seen after a series of ECT. About 30-minutes after the treatment the patient awakens from sleep. While confused at first, the patient is soon oriented enough to eat breakfast, and return home if the treatments are being done in an outpatient setting.