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Electricity against depression: This may affect who benefits from the treatment

A new study shows that biological differences in the body may help determine who benefits from electroconvulsive therapy (ECT) for severe depression.

Researcher and radiographer demonstrate MRI scan procedure with patient on scanner table.
It's common for patients who receive ECT treatment to have an MRI scan before treatment. This photo is from a demonstration.
Paul André Sommerfeldt COMMUNICATIONS ADVISER
Presented by: Presented by: Presented by: University of Bergen
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Electroconvulsive therapy (ECT) is considered one of the most effective treatments for patients with severe depression. In the past, this was called electroshock treatment, but that term is not used today.

Even so, it is often offered only as a last resort when other interventions have failed.

A new international study led by researchers at the University of Bergen now provides new insight into why some patients benefit from ECT while others do not.

Induces an epileptic seizure

ECT uses a controlled electrical current to induce a brief, medically supervised seizure while the patient is under anaesthesia.

It is used to treat severe depression and other serious mental health problems where medication or therapy has not worked or is unsuitable. 

Stephanie Le Hellard is a co-author of the study and is committed to reducing the stigma surrounding ECT treatment.

In the new study, blood samples from nearly 100 patients in Norway and Germany were analysed. The researchers looked for epigenetic patterns and immune-related markers. These are biological traces that can say something about how the body functions.

Found differences in DNA before the treatment started

The most striking finding was that patients who later responded well to ECT already had clear biological differences in their DNA before treatment began, compared with those who did not have as good an effect. 

The ECT treatment itself, however, did not lead to measurable changes in gene expression.

“Patients who responded well stood out based on specific biomarkers,” says Professor Stéphanie Le Hellard at the University of Bergen.

Radiologist and researcher Leif Oltedal adds that these biomarkers can say something about how easily the brain can form new connections.

“We believe ECT works by disrupting rigid networks in the brain and making it more flexible,” he says. 

May lead to more precise treatment

There are currently few objective tools that can help in choosing the right treatment for patients with severe depression. 

The study could therefore help pave the way for more targeted, personalised treatment.

“The lack of such tools has contributed to long periods of trial and error for patients with serious illness,” says Le Hellard.

She adds that the treatment still carries significant stigma. 

Le Hellard explains that today, ECT is a highly controlled medical procedure with close monitoring of the patients.

Radiologist and co-author Leif Oltedal at the University of Bergen says the study’s findings are promising.

May open the door to more personalised psychiatry

To reduce stigma around ECT, it's important to have scientific understanding of why the treatment works or some, but not for others.

Le Hellard argues that strengthening the biological knowledge base is not only a scientific goal, but also a clinical and ethical responsibility.

The researchers hope the new findings may open the door to a more personalised psychiatry. 

Oltedal notes that a future scenario where a simple blood test could help determine the best treatment for each patient would be a major step forward. 

He says that the next step will likely be to take part in an international initiative to collect and analyse blood samples from patients receiving ECT treatment.

At the same time, the researchers stress that the findings are not final and need to be confirmed in larger studies.

Despite this, Oltedal finds it encouraging that the findings were replicated in two independent datasets from Norway and Germany.

Possible side effects of the treatment

ECT is typically well tolerated. Some patients may experience side effects such as headaches, nausea, and muscle pain. Memory problems are relatively common, but they are usually temporary and tend to resolve within a few weeks or months after treatment. In some cases, however, patients may experience more pronounced cognitive effects.

(Source: Great Norwegian Encyclopedia)

Reference: 

Stavrum et al. Epigenetic and blood markers associated with response to electroconvulsive therapy in patients with depressive disorders, Translational Psychiatry, 2025. DOI: 10.1038/s41398-025-03772-y

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