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Is Electroconvulsive Therapy a Treatment Option for BPD?

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Updated February 27, 2009

Question: Is Electroconvulsive Therapy a Treatment Option for BPD?
Electroconvulsive therapy (ECT) is a psychiatric treatment with a long and controversial history. Is electroconvulsive therapy effective for borderline personality disorder (BPD)?
Answer:

Electroconvulsive therapy, or ECT, is a psychiatric treatment that involves briefly passing an electrical current through the brain. This procedure is not used to treat borderline personality disorder (BPD), but it is used to treat severe depression that has not responded to adequate medication trials and under other clinical circumstances. Since many people with BPD also suffer from depression, some people who receive ECT have BPD.

While ECT does have a long and controversial history, it is recognized as an effective treatment for severe depression by the American Psychiatric Association (APA). The APA has issued guidelines for the use of ECT that ensure that the procedures are carried out with your safety and well-being in mind. Some people do experience unwanted side effects from ECT (for example, memory loss), so you should talk about the risks and benefits with your provider if you are considering ECT.

That said, there is research that suggests that ECT is not as effective in treating depression for people who also have BPD. The research literature in this area is small and inconsistent, so it does not mean that people who have both depression and BPD should not receive ECT, but it is something to consider when you are weighing the risks and benefits.

Sources:

American Psychiatric Association. “Practice Guideline for the Treatment of Patients with Borderline Personality Disorder.” American Journal of Psychiatry, 1581-52, 2001.

Weiner RD. Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training, and Privileging: A Task Force Report of the American Psychiatric Association, (2nd ed.), American Psychiatric Publishing, 2001.

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