Electroconvulsive Therapy: Mechanisms, Clinical Considerations, Future Directions
How Does Electroconvulsive Therapy Work and What’s Its Future?
Electroconvulsive therapy works through multiple neurobiological mechanisms including enhanced neuroplasticity, neurotransmitter normalization, anti-inflammatory effects, and promotion of neurogenesis, with modern protocols achieving 40% or greater symptom reduction and response rates exceeding 80% in treatment-resistant depression. A comprehensive review published in Harvard Review of Psychiatry examines ECT mechanisms, clinical applications, and future directions, showing that controlled seizure activity leads to widespread brain changes that rapidly reverse severe depressive symptoms.