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.

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Antidepressant Efficacy of Sudarshan Kriya Yoga (SKY) in Melancholia: A Randomized Comparison with Electroconvulsive Therapy (ECT) and Imipramine

Introduction

Sudarshan Kriya Yoga (SKY) is a breathing-based technique that involves rhythmic hyperventilation at different rates. This randomized controlled trial compared the antidepressant efficacy of SKY with two standard treatments for melancholic depression: electroconvulsive therapy (ECT) and imipramine (IMN).

Background on Sudarshan Kriya Yoga

Sudarshan Kriya (Su=right, Darshan=vision, Kriya=procedure) was developed by spiritual guru Pundit Ravi Shankar of the Art of Living Foundation, Bangalore, India. Originally practiced as a stress-management strategy, it was adapted for clinical purposes by removing meditative and philosophical components, focusing solely on specified rhythms of breathing.

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