The idea for electroconvulsive therapy came from a Rome slaughterhouse
Ugo Cerletti got the idea for shock treatment after watching pigs being stunned with electricity before slaughter. His 1938 procedure spread worldwide, was vilified after One Flew Over the Cuckoo's Nest, and quietly returned. Today, given under anaesthesia, ECT brings remission for roughly half to 60 percent of people with severe depression.
ECT passes an electric current through the brain to trigger a generalised seizure. Its roots run deep: seizure-inducing agents were tried on mental illness from the 16th century, and a 1785 journal described giving camphor by mouth to provoke fits. Electricity entered medicine in the 18th century, with Benjamin Franklin claiming an electrostatic machine cured a woman's hysterical fits. In 1934 the Hungarian psychiatrist Ladislas Meduna, wrongly believing schizophrenia and epilepsy could not coexist, began inducing seizures with camphor and then metrazol.
Cerletti had already produced convulsions in dogs with shocks to the head. With his assistant Lucio Bini at Sapienza University he refined the parameters and in 1938 treated a man with delusions. Electricity soon displaced metrazol because it was cheaper, less frightening and easier; by 1940 it had reached England and the United States. The two inventors were nominated for a Nobel Prize but never won, and patent rivalry soured their partnership.
Early treatment was brutal. In the 1940s and early 1950s patients convulsed fully without muscle relaxants, occasionally breaking or dislocating long bones. Psychiatrists tried curare to soften the spasms, and in 1951 the safer synthetic relaxant suxamethonium made modified ECT widespread. Brief-pulse currents and one-sided electrode placement were introduced to reduce confusion and memory loss, though they took years to catch on. Rising antidepressant use and grim portrayals, above all Big Nurse's weapon in One Flew Over the Cuckoo's Nest, drove a decline from the 1950s to the 1970s. The American Psychiatric Association backed ECT for depression in a 1978 task-force report, and use began rising again in the 1980s.
A modern course usually means two or three sessions a week under anaesthesia until symptoms lift. It is used for major depression, mania and catatonia when other treatments fall short, and it reduces suicide risk and outperforms antidepressants and magnetic stimulation in severe cases, though relapse is common without maintenance. Its physical risks resemble brief general anaesthesia, with confusion and temporary memory loss the usual after-effects, and it is among the gentlest options for the foetus when a pregnant woman is severely depressed.
Source: Electroconvulsive therapy
