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Electroconvulsive Therapy: A Second Opinion
Note: The information on this
website is not a substitute for
diagnosis and treatment by a qualified, licensed professional.
Side effects: Effects on memory and cognition
* In Freeman and Kendell's 1986 study, 74% of patients mentioned "memory impairment" as a continuing problem, and "a striking 30% felt that their memory had been permanently affected." The authors themselves admit that these symptoms were probably underreported because the patients were interviewed by the same doctors who treated them.
* Despite this remarkably high incidence of impairment, the 1990 American Psychiatric Association task force cites Freeman and Kendell as indicating "a small minority of patients, however, report persistent deficits."
C. Freeman and R. Kendell, Patients' experience of and attitudes to electroconvulsive therapy, Annals of the New York Academy of Sciences 462 (1986), 341-352.
* "Controlled studies by Janis, carried out at Yale University, showed extensive, permanent loss of important personal memories and life history following routine ECT."
Electroshock: scientific, ethical, and political issues. Peter R. Breggin. International Journal of Risk & Safety in Medicine 11 (1998) 5-40 IOS Press, citing I.L. Janis, Memory loss following electroconvulsive treatments, Journal of Personality 17 (1948), 29-32; I.L. Janis, Psychological effects of electric convulsive treatments, Journal of Nervous and Mental Disease 111(1950), 359-397, 469-489; I.L. Janis and M. Astrachan, The effect of electroconvulsive treatment on memory efficiency, Journal of Abnormal Psychology 46(1951), 501-511.
* "Many of the patients in a 1995 study developed irreversible retrograde amnesia that lasted at final testing two months after their last ECT….Following ECT, the four groups of patients lost or distorted the following percentages of their previously recalled memories: low-dose unilateral (29.8% loss), high-dose unilateral (26.8% loss), low-dose bilateral (47% loss) and high-dose bilateral (38.5% loss). These are extraordinary figures reflecting massive losses of retrograde memories of important past personal events."
Electroshock: scientific, ethical, and political issues. Peter R. Breggin. International Journal of Risk & Safety in Medicine 11 (1998) 5-40 IOS Press citing C. Sobin, H.A. Sackeim, J. Prudic, D.P. Devanand, B.I. Moody and M.C. McElhiney, Predictors of retrograde amnesia following ECT. American Journal of Psychiatry 152 (1995), 995-1001.
* A 1998 study of patients exhibiting confusional states (similar to post-traumatic amnesia among patients with head injury) following ECT show accelerated forgetting on a visual recognition memory task. Accelerated forgetting may reflect the effect of disrupted cerebral metabolism on either "consolidation" or memory "binding" processes.
Lewis P, Kopelman MD. Forgetting rates in neuropsychiatric disorders. J Neurol Neurosurg Psychiatry 1998 Dec;65(6):890-8.
* Cognitive deficits are an undesirable effects of shock therapy (ECT). These include linguistic information processing difficulties and memory dysfunction as cognitive impairments associated with ECT.
Durr AL, Golden RN. Cognitive effects of electroconvulsive therapy: a clinical review for nurses. Convuls Ther 1995 Sep;11(3):192-201
* There is a gap between scientific studies of ECT, which conclude that side effects are short term and narrow in scope, and the reports of patients. The existing research paradigm fails to consider the potential for devastating and permanent memory loss with ECT.
Electroconvulsive therapy and memory loss: a personal journey. Donahue AB. J ECT 2000 Jun;16(2):133-43
* "Shortly after ECT, patients recalled fewer events and event details than controls, with the deficits most marked for impersonal compared with personal events. At the 2-month follow-up, patients had reduced retrograde amnesia, but continued to show deficits in recalling the occurrence of impersonal events and the details of recent impersonal events. The amnestic effects of ECT are greatest and most persistent for knowledge about the world (impersonal memory,) compared with knowledge about the self (personal memory), for recent compared with distinctly remote events, and for less salient events."
The effects of electroconvulsive therapy on memory of autobiographical and public events. Lisanby SH, Maddox JH, Prudic J, Devanand DP, Sackeim HA. Arch Gen Psychiatry 2000 Jun;57(6):581-90
* "Autobiographic memory failures, if added across a course of ECT, may produce gross memory gaps that may be disconcerting to a patient and a patient's family, because the patient's sense of continuity with his or her own past may be disrupted."
W. Daniel, H. Crovitz, R.D. Weiner and H. Rogers, The effects of ECT modifications on autobiographic memory, Biological Psychiatry 17 (1982), 919-924. Cited in Electroshock: scientific, ethical, and political issues. Peter R. Breggin. International Journal of Risk & Safety in Medicine 11 (1998) 5-40 IOS Press.
* "…individuals whose prior treatments had included ECT were inferior to normal control subjects and to patients who had been spared ECT, and this inferiority was apparent on the following measures: verbal and nonverbal fluency, delayed alternation performance, tactual maze learning, continuous recognition of verbal and nonverbal material, delayed recall of a complex drawing, recognition of faces and houses, and identification of famous public figures. In some cases, the degree of deficit was related to the number of ECT received, patients who had been given more than 50 ECT being significantly worse than those who had sustained fewer than 50."
Teuber, J.L., Corkin, S. & Twitchell, T.E.: A study of cingulotomy in man. Report to the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. 1976. Cited in Electroshock: scientific, ethical, and political issues. Peter R. Breggin. International Journal of Risk & Safety in Medicine 11 (1998) 5-40 IOS Press.
The issue is summed up succintly in the title of a year 2000 article in the prestigious Nature journal. "ECT damage is easy to find if you look for it."
Sterling P. ECT damage is easy to find if you look for it. Nature 2000 Jan 20;403(6767):242.
* "Publicly available data from the state of California's Department of Mental Health reveals that over 99% of ECT recipients complain of memory loss 3 months following treatment, with the average number of ECT sessions being 5 to 6."
Appendix to John Breeding, Ph.D. Electroshock. Based on an article published in the Journal of Humanistic Psychology, Winter 2000, Vol. 40, No. 1, pp. 65-79, citing A. Lazarow, Chief, Office of Human Rights, California Department of Mental Health, 1996.
* "In a chapter on the cognitive effects of ECT in a psychiatry textbook, Sackheim indicates that cognitive effects (disordered thinking), particularly amnesia, can be long lasting after shock."
Appendix to John Breeding, Ph.D. Electroshock. Based on an article published in the Journal of Humanistic Psychology, Winter 2000, Vol. 40, No. 1, pp. 65-79, citing Sackeim, in Cognitive Disorders: Pathophysiology and Treatment, edited by Moos, et al 1992.
* "The conclusion that amnesia can be a long lasting effect of shock is arrived at by both Squire and Weiner in separate studies.
Squire, et al. Retrograde amnesia and bilateral ECT: Long term follow-up. Arch Gen Psych 1981;38:89-95. Weiner, et al. Effects of stimulus parameters on cognitive side effects Ann NY Acad Sci 1986;462:315-325.