What is the most common complication of ECT?

Electroconvulsive therapy (ECT) is recognized for being an effective treatment for severe depression and other psychiatric disorders. While ECT does come with its share of potential complications, the most common complication involves the aspiration of emesis into the lungs. This risk primarily arises from the anesthesia and muscle relaxants used during the procedure, which can depress gag reflexes, making it easier for patients to aspirate if vomiting occurs.

Because ECT is administered under general anesthesia, it's particularly crucial to ensure that the patient's airway is protected to prevent aspiration, as this can lead to serious respiratory complications like aspiration pneumonia. This complication is often more prevalent due to the rapid administration of ECT and the transient nature of the patient’s loss of consciousness.

While fractures from convulsions, headaches, and chest pain can also occur, they are generally less frequent or less severe in comparison to the aspiration risk posed during ECT. Thus, recognizing aspiration as a prevalent complication underscores the importance of careful monitoring and procedural precautions during ECT sessions to safeguard the patient’s airway and minimize risks.