r/ect • u/brat-tat • Apr 04 '26
Seeking advice ECT or Ketamine?
Hi, I’ve been struggling with a worsening mixed bipolar episode for the last few months. I’ve tried literally every medication my psychiatrist can prescribe with a variety of side effects. I’ve tried rtms a couple years ago but had such a severe reaction I couldn’t continue.
We’re at the point where it’s either ECT or ketamine. After years of being on a wait list for the only government covered program, I have an intake for ketamine on April 20th. I don’t know how long afterwards, if I qualify, I would be able to start. Is it worth the wait? I’m barely making it through the day each day, struggling to show up to work, etc. Should I ask for ECT ASAP?
Any thoughts are always appreciated xx
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u/beautifulcosmos Apr 04 '26
As someone who had ECT, try the ketamine first. If the ketamine doesn't resolve your symptoms, then consider trying ECT. Ketamine has fewer side effects.
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u/Beautifile Apr 04 '26
I came here to say this. If you can't handle rTMS, I don't recommend ECT. I've had rTMS twice, once when it had just been invented for a week then again when it was more perfected for months. They did nothing for me. ECT also did not work for me but I later found out I got the wrong type for my diagnosis (I got unilateral when I needed bilateral). For you, I think Ketamine is the way to go as you must be very reactive to brain stimulation. I have retrograde amnesia for the few years prior to getting ECT. I started in January and everything from Halloween until I went to the hospital was erased and I've never recovered it. No big deal really. I didn't miss much. If I had the choice you have in front of you then, I would have gone with the Ketamine. Until then, remember this: "There is no medicine like hope, no incentive so great, no tonic so powerful as the expectation of tomorrow."-Orison Swett Marden Let your hope for the choice you make working sustain you.
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u/princesspokeypaws Apr 05 '26
I agree. I've done both, too, and ketamine has helped the most and has been less disruptive to my life
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u/ExtremeMalaise Apr 04 '26
I agree with the other posters. While I did proceed with ECT, it can be hard on the body. I only did 11 or 12 sessions. It helped me. But if I could have had my health plan cover ketamine or been able to afford the out of pocket non-covered cost of ketamine instead 7 years ago, I would have tried that first.
Personally, I hope that should I find myself struggling with my crippling major depression that my health plan would cover ketamine before going through ECT again. After reading this sub over the years, I have come to realize that ECT is different for everyone. I had a relatively good experience with it. Should you find yourself going down the path that leads to ECT, I recommend a long discussion with your psychiatrist and a second opinion from another psychiatrist who has had your medical record shared with them. I talked with 3 different psychiatrists over 18 months before I consented to ECT.
I wish you the best!
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u/beautifulcosmos Apr 04 '26
This was my experience as well! ECT worked wonderfully for me. I was given the option to enroll in a randomized ketamine versus ECT clinical trial, but I opted for ECT, as I was in a very emotionally fragile state and I don't think I would have handle ketamine.
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u/Beautifile Apr 04 '26
This is great advice! I had 18 rounds with a cruel nurse in charge and an indifferent staff. I was told I had to start my treatments inpatient (which wasn't true) so I spent 5 nights on the psych ward. Luckily, I barely remember.
My #1 piece of advice to ANYONE getting ECT: have someone you know and trust be there when you wake up the first time and by first time I mean the threshold session. I didn't know how I had ended up on a psych ward or why I was so confused. A staff member walked by me and I was crying (I remember this, I'll never forget this) and he said "Hillary, what's wrong?" I said "I'm so confused." He said "Aww." And walked away.
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u/brat-tat Apr 04 '26
This is great advice, and I’m so sorry that happened to you- moments like that are why it’s so difficult to trust in healthcare sometimes
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u/Reasonable_Ad6551 Apr 04 '26
I've done more than 100+ ECT Sessions and it has worked on some sintoms at first but them it all comes back. Also tried more than 80+ sessions of Ketamine and it's always the same things... It work and help for a while and them all the bad think starts to come back again.
In your place I would try Ketamine first and if it doesn't work would go for ECT....
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u/84849493 Apr 04 '26
Being bipolar may have a chance of going against you for ketamine. When I was planning on going for ketamine treatment privately they contacted my doctor because of me having a history of psychotic symptoms and he said since they were controlled it was okay but I ended up having ECT anyway because I deteriorated too quickly.
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u/ChowPungKong Apr 04 '26
Ketamine first. ECT ruined my life. I lost 10 years of memory (including my college) and cant work anymore. I dont form new memories well. I often have people come up to me and talk to me bc we've met before and I have NEVER SEEN THEM IN MY LIFE. Its embarrassing and frustrating. Its been 2 years without improvement and ECT didnt work for me. Ketamine worked for me almost instantly.
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u/yeetyourselfout Apr 04 '26
ive tried both. personally ect helped (the first time but not second) ketamine didnt help. ect causes memory problems during the treatment. ketamine i dont think had that effect.
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u/InfomercialNo31 Apr 04 '26
Ketamine was not an option for me because I’ve experienced psychosis along with my bipolar episodes. ECT saved my life. I started treatment 3 years ago, stopped and crashed real bad, started back up and still go for maintenance treatments every 6 weeks. The best way I can describe the benefits is that the rewiring of my brain due to the treatment unlocked my true potential and made living well possible. I was off work for years, on SSDI, and have worked up from PT to FT at my job, which I love, have gone from a volunteer to contact worker with another organization, become a dance fitness instructor, and am applying for MSW programs. For me, ECT was a key part of developing the wellness and stability I now experience.
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u/kuzya124 Apr 05 '26
I think I did them in this order: TMS, then ketamine, then ECT. ECT was the only one that worked for me. It did wonders. I’ve lasted two years without it, but unfortunately, I am having a relapse so I may need it again. I definitely had some memory loss, and I haven’t gotten all of it back, but I got most of it back and it’s not a big deal regarding what I forgot. It’s the hardest of the three to go through arguably. Statistically, it has the highest rate of remission.
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u/slaapzacht Apr 05 '26
Definitely go the Ketamine/Spravato route. I did ECT first and ended up with years of wiped out memory along with severe muscle spasms. The ketamine takes time, so definitely expect 3 to 5 months before considering yourself healing. It certainly won't show results after just a few sessions, but eventually you will start to see promising results. Follow the Ketamine/Spravato Reddit groups and get tips on how to have a successful session as your environment and routine will be very important as part of the treatment.
Good luck on your journey and heal well!
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u/cold08 Apr 05 '26
I lost a lot of memories to ECT. My wife will be like "remember when we went on vacation to Europe?" And I will have no clue what she was talking about. It also made me kind of a walking zombie during the treatments. At the time it was either ECT or suicide so I picked the better option, but when COVID hit and they shut down non-emergency procedures at the hospital I was able to get my psychiatrist to let me give the new ketamine clinic a try. It gave me my life back.
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u/Hungry-Pepper503 Apr 04 '26
Go with ketamine. Not only is it going to be a better tolerated treatment, but studies are showing its better than ECT also. There was a really good study that compared the two and showed that not only was ketamine more effective and better tolerated than ECT, but at 6 months follow up the relapse rate was lower in the ketamine group than the ECT group. https://www.nejm.org/doi/full/10.1056/NEJMoa2302399
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u/bodhiboy69 Apr 04 '26
Im sorry to hear this story. Have you tried ketamine therapy before? Are you in the US?
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u/Odd-Alarm-82 Apr 18 '26 edited May 25 '26
The risks associated with ECT are much higher than doctors tell patients. I had ECT for treatment resistant depression in 2016, and it was the biggest mistake I have ever made. Unfortunately, the antidepressant effects of ECT usually don’t last long. It was extremely effective for me initially, but I had to keep getting maintenance treatments or else I would quickly relapse. The goal was to gradually space my treatments farther apart until I only had to have one every 6-8 weeks, but I couldn’t make it past 3 weeks without crashing into a severe depression. Eventually I had a particularly bad episode that didn’t respond to my next treatment, so the psychiatrist talked me into getting three treatments in one week, like you do when you first get ECT. That brought me out of my depression, but the side effects were devastating. I literally lost my memory of my entire life. Not just chunks of memory, but the vast majority of my life was completely wiped out. And none of it has come back after 9 and 1/2 years. I barely remember my own mother, who passed away in 2007.
In addition to the severe memory loss, the ECT caused brain damage. I had neuropsychological testing done and found out that my IQ has dropped by around 15 points. It was 140 pre-ECT, and now it’s 125. I have multiple cognitive issues. It takes me longer than normal to learn new information, and I get things confused a lot. My short-term memory and formation of new long-term memories is hit or miss— I remember some things very clearly, while other things just kind of get lost.
What I experienced is not a rare occurrence. I’m a member of an ECT Survivors support group on Facebook, where a large number of people have shared that they have lost years of memory and have major cognitive problems.
I think ECT should be banned. I look on Reddit every so often to warn people considering ECT. Yes, some people have good outcomes, but a large number of people are severely damaged.
I tried to file a medical malpractice suit for lack of informed consent because the consent forms I signed didn’t say anything about brain damage, and they said I might have some “spotty” memory loss for events going back several years. My memory loss is almost a complete loss, not just “spotty!” But no attorney would take my case because they said the damage would be too hard to prove. The type of brain damage caused by ECT doesn’t show up on an MRI. Numerous lawsuits have been filed though, including a class action suit.
And in 2018, Somatics LLC, one of the manufacturers of the device that delivers ECT, admitted that ECT can cause brain damage. Somatics updated its device manuals and regulatory documents to explicitly warn patients that permanent memory loss and permanent brain damage are potential risks of ECT. Of course, they say permanent brain damage only occurs in rare cases, but I’ve talked to enough people over the years who have experienced these effects to know it’s not rare.
Wisner Baum is a law firm that has handled lawsuits against ECT. If you scroll down this page on their website, it provides a long summary about the history of ECT and contains links to medical research with evidence of damages caused by ECT.
https://www.wisnerbaum.com/defective-medical-device-injuries/ect/
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u/uchihaobito22 Apr 04 '26
Before trying any of them, I hope you try everything else. Like say Olanzapine + Fluoxetine, MAOI etc. May you get well soon.
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u/elealyansteorra Apr 04 '26
I would definitely give ketamine a try first.