The effectiveness of electroconvulsive therapy: A literature review

In the paucity of easily available information on ECT, the below paper looks at the available literature and comes to some conclusions. I hope the FDA takes a look at it today when it begins its review of the devices.

I can tell you that I was “offered” ECT as treatment once for what was essentially a drug induced stupor I found myself in. Fortunately I did not opt to have it administered, but I don’t know why as I was not told about any of the grave risks that I’m familiar with today having met many people who have had ECT now. I suppose the mere thought of it was enough to turn me off as I do remember feeling deeply unsettled by the idea that an electrical charge would be passed through my brain.

Since then I’ve watched a friend go through ECT who DOES NOT REMEMBER what a mess he was while he was getting it. It was terrifying to watch him and this was well before I became as critical as I am now about psychiatry in general. He was horribly scrambled. Plain and simple. I spent a lot of time with him and his amnesia was such that he couldn’t remember what he said or did 2 minutes after he said or did it. It was extremely disturbing as well as simply annoying. Having a conversation with someone who immediately forgets everything that is said is rather challenging to say the least. His condition went on for weeks. And today he simply doesn’t have a memory of how disoriented he was because he can’t remember forgetting everything!! so he really doesn’t understand what happened. I can say that he unequivocally thinks the ECT was useless. He did not get any relief from the depression he was treating. It also didn’t stop him from entering a frightening suicidal phase. Luckily he is still alive today and doing much better with no current psychiatric intervention at all. He gave up on it all.

Memory loss is much more complete and total for others who forget chunks of their former lives. My friends situation was different from what often gets reported, but it was clearly indicative of a trauma to the brain. Denying that, as many doctors do, is ludicrous.

The paper: The effectiveness of electroconvulsive therapy: A literature review

SUMMARY. Aim – To review the literature on the efficacy of electroconvulsive therapy [ECT], with a particular focus on depression, its primary target group. Methods PsycINFO, Medline, previous reviews and meta-analyses were searched in an attempt to identify all studies comparing ECT with simulated-ECT [SECT]. Results – These placebo controlled studies show min- imal support for effectiveness with either depression or ‘schizophrenia’ during the course of treatment (i.e. only for some patients, on some measures, sometimes perceived only by psychiatrists but not by other raters), and no evidence, for either diagnostic group, of any benefits beyond the treatment period. There are no placebo-controlled studies evaluating the hypothesis that ECT prevents suicide, and no robust evidence from other kinds of studies to support the hypothesis. Conclusions Given the strong evidence (summarised here) of persistent and, for some, permanent brain dysfunction, primarily evidenced in the form of retrograde and anterograde amnesia, and the evidence of a slight but significant increased risk of death, the cost-benefit analysis for ECT is so poor that its use cannot be scientifically justified.

PDF file here Thanks to PsychRights for housing the file.

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