Seeing the problem up close
Jordy Rovers is a PhD candidate at the Radboud UMC, where he works part-time at the Department of Psychiatry. He is also affiliated with the Donders Institute and works as a psychiatrist at CWZ, combining clinical work with research. This dual perspective gave him a clear view of the challenges patients face after ECT.
ECT is used for severe psychiatric disorders, such as depression, psychosis, and catatonia. It works by modulating brain activity with small electrical stimulation. This causes a short, controlled burst of activity while patients are under full anesthesia, receive muscle-relaxing medication, and are closely monitored. “ECT is not a treatment to use lightly,” Jordy emphasizes. It is usually used when someone is severely ill and other treatments have not worked. Jordy also explains that “Patients are not aware of the procedure itself, and while there can be cognitive side effects, it is a very effective treatment for those who need it most”.
The hidden struggle after treatment
Through his daily work, Jordy noticed an important problem: patients who respond well to ECT often relapse after completing their treatment. “I saw it happen in practice,” he says. “Patients would improve, but after a few months, many would experience another depressive episode. That made me think: how can we prevent this?”
Learning from experts
This question became the focus of his research on relapses after ECT. Traditional clinical trials are often challenging, both ethically and practically. To address this, Jordy used a Delphi consensus study, which gathers expert opinions to reach agreement on how patients should be treated after ECT. “There is a lot of knowledge in clinical practice, but it is not always reflected in scientific evidence,” Jordy says. This makes expert consensus an important step in improving care.
One size doesn’t fit all
The study revealed two key conclusions. First, specific medication (lithium + antidepressant) should be started or continued after ECT. “It is something that is already advised, but in practice, not always done,” Jordy notes. Instead, treatment should continue and be adjusted to the patient’s needs. Second, care should be personalized. High-risk patients – those with severe or recurrent depression, comorbidities, or a history of relapse – may need extra support. For these patients, the experts advise gradually reducing ECT instead of abruptly stopping ECT, as is often practiced at this moment.
Making recovery last
Looking ahead, Jordy hopes for structured relapse-prevention programs that combine medication, therapy, and cognitive support. “My vision is that patients leaving ECT will have a clear plan,” he says, including guidance on medication, coping strategies, and recovery support in daily life. “That way, fewer people have to go through repeated treatments.”
He also points to a broader challenge: implementing these programs in practice. “The focus in psychiatry is often on treating the immediate illness, but we need to look at what happens after treatment. That’s where we can really make a difference.”
Ensuring that recovery continues after treatment may be the next crucial step, turning short-term success into lasting mental health.
If you want to learn more about ECT visit www.ectinfo.nl.