Brief Answer:
ECT has specific indications

Detailed Answer:
Hi, thanks for writing through HCM.

I have read your query and understood that you have event onset depression [means it has started after some significant stress], ADD [means attention deficit disorder] and some anxiety symptoms. You are on antidepressant drugs for last 8 years, so I am considering that you have been given more than 2 antidepressants with inadequate response. [I am considering here that you have not improved completely since the depression has started]

At present you are taking Lexapro 20 mg for depression, adderrall 90 mg for ADD and klonopin for night time anxiety.

After reviewing your treatment duration and drugs, I am considering that you have treatment resistant depression. ECT [electroconvulsive therapy] is indicated in resistant depression. In depression, ECT is indicated for psychotic depression, depression with catatonic symptoms, severe depression with suicidal ideation and treatment resistant depression.

[My answer is based on my theoretical and practical knowledge, It may differ from what has been written in books and from other professionals]

Now, Answering your questions:
1. Considering your current treatment: Klonopin should be withdrawn because it also acts as a anticonvulsant, so efficacy of ECT would be compromised. In my patients I used skip the dose of benzodiazepins on night before ECT is planned. Lexapro do not have any contraindication for ECT while adderall can lower seizure threshold, so it should be given cautiously in a patient undergoing ECT. Adderall is not a contraindication for ECT.
2. Now-a-days most of the psychiatrist prefer modified ECT, in which patient is given general anesthesia and then ECT is given.
3. It is safe, there is no harm to person's life. Yeah, because anaesthesia is given there are risks associated with it.
4. After the ECT, patient can have heaviness over head, mild fever, fatigue etc. on the same day. ECT can cause memory problems, both anterograde and retrograde amnesia can occur. These memory disturbance can take 1 month to 1 year time to recover completely. Sometimes, there are very less chance of seizure continuing for more than 40 seconds during ECT, but it can be managed easily with anaesthetist team.
5. ECT is very effective and life saving treatment. In a patients with suicidal ideation, ECT saves lives.
6. Because you have resistant depression, you can have benefit from ECT but it can relapse and you may need to take another round of ECTs.
7. ECTs are usually given alternate days for maximum of 8 to 10. I usually prefer giving 6 at beginning, then the number can change depending upon the response and benefit patient is getting.
8. ECT is to be given in well equipped room which have all the emergency and critical care instruments available.

You can discuss all of these issues with your primary care physician and follow his advice.

Hope I have answered your query. If you have further query then I shall be happy to help.
Wish you good health.

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Brief Answer:
Klonopin does not create any physical complications

Detailed Answer:
Hi, thanks for writing again.

Klonopin decreases efficacy of ECT by increasing seizure threshold because it act as a antiepileptic drug.

It does not possess any major risk for physical complications.

If a person is on higher dose of klonopin like 2 to 4 mg and he will be give ECT then there are higher chances of him going in delirium. This delirium can be easily managed by simply withdrawing the culprit drug but it will be horrible experience for patient as well as care takers.

Hope I have answered your query. If you do not have further clarifications then close the discussion and rate the answer.
wish you good health.

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