Fact Sheet (pdf)
Psychiatric Neurotherapeutics Program (PNP)
Stephen J. Seiner, MD
Director, Psychiatric Neurotherapeutics Program (PNP)
Director, Electroconvulsive Therapy (ECT) Service
Oscar G. Morales, M.D.
Associate Director, Psychiatric Neurotherapeutics Program (PNP)
Director, Transcranial Magnetic Stimulation (TMS) Service
Paula Bolton, RN/NP/MS
Nurse Director, Psychiatric Neurotherapeutics Program (PNP)
The Psychiatric Neurotherapeutics Program (PNP) at McLean Hospital specializes in the neuromodulatory and neurostimulatory treatment of psychiatric disorders. It offers transcranial magnetic stimulation (TMS), a new and promising method for treating severe depression, as well as electroconvulsive therapy (ECT), a highly effective conventional intervention for chronic depression, mania, catatonia and schizophrenia. TMS and ECT are the first in a line of clinical services to be offered through the program.
With components in clinical care, research and education, the PNP is dedicated to improving the quality of life for individuals with a broad range of psychiatric illnesses.
Its collaborative team approach is aimed at maximizing the effectiveness of psychotherapy, medication management and psychosocial treatments already offered at McLean with emerging techniques, technologies and interventions.
McLean Hospital is a leading specialty center for electroconvulsive therapy (ECT). The ECT Service, headed by Stephen Seiner, MD, director, and Oscar Morales, MD, associate director, has been conducting ECT treatments for more than 60 years.
A highly qualified staff of psychiatrists and registered nurses, along with anesthesia experts from the Massachusetts General Hospital, have extensive experience in administering ECT and in caring for patients who undergo the procedure for such treatment-resistant conditions as depression, mania, catatonia and some psychotic illnesses.
The Decision to Use ECT
Although ECT was introduced in the 1930s, its therapeutic use today is very different from what is portrayed as “shock treatment” in books and films. ECT is a relatively safe and effective procedure, providing relief from serious psychiatric symptoms much sooner than other therapies, such as medication and psychotherapy.
ECT is reserved for patients who have not responded to medication, who are having excessive
side effects from medication or who are severely suicidal. Statistically, approximately 80 percent of patients treated with ECT respond well and get relief from their symptoms. An initial consultation with one of McLean Hospital’s ECT psychiatrists offers the opportunity to get information about ECT.
What is ECT?
During electroconvulsive therapy, a patient is anesthetized and a small amount of electrical current is used to stimulate the brain. This produces a modified seizure, which, in turn, changes the activity of the brain. Some of these changes are similar to those seen with certain antidepressant medications in the way they relieve symptoms. The medications used for anesthesia prevent injury and patients feel no discomfort during the procedure.
Are There Risks to ECT?
Like any medical procedure, ECT does pose some risk. To minimize the risk, every patient has a medical clearance, including a physical examination, blood tests and an electrocardiogram (EKG)before beginning ECT. The physical examination is performed at McLean by a physician from the hospital’s Internal Medicine Department.
Potential Side Effects
ECT has some possible side effects, such as headache, muscle pain, memory problems and rarely, nausea and vomiting. Most people who have treatments report very few side effects.
The great majority of patients will have only minor problems with memory, though some will experience no difficulties at all. While these problems usually subside, there is no way to predict their extent. The psychiatrist will discuss this potential side effect in greater detail during consultation.
ECT at McLean Hospital
Most patients will have between eight and 12 treatments over a period of three to four weeks. If the patient has excellent results, it is possible to transition to continued or maintenance ECT, if indicated. The psychiatrist, in collaboration with the patient, will decide how many treatments are needed.
Patients may have an entire series of treatments either on an inpatient or outpatient basis.
The outpatient service allows patients to be treated and on their way home within two and
The staff of the ECT Service, after years of providing treatment and listening to feedback from patients, has made having ECT as comfortable as possible. Our staffing model allows patients to have their own nurses throughout the treatment and recovery period.
McLean accepts Medicare, Massachusetts Medicaid and many private insurance and managed care plans.
For further information or a referral for consultation, please call 617.855.2355 and
press 2 to speak to an ECT nurse (ECT nurses are most available in the afternoons,
Monday through Friday).
About McLean Hospital
U.S. News & World Report named McLean America's #1 Hospital for Psychiatry in 2013 . McLean Hospital is the largest psychiatric facility of Harvard Medical School, an affiliate of the Massachusetts General Hospital and a member of Partners HealthCare. For more information about McLean visit us on www.facebook.com/ McLeanHospital or follow the hospital on Twitter@McLeanHospital.