        |
Electroconvulsive Therapy: A Second Opinion
Note: The information on this
website is not a substitute for
diagnosis and treatment by a qualified, licensed professional.
o ECT emerged with no scientific evidence, and the absence of other suitable therapy for psychiatric illness was decisive in its adoption as a treatment. ECT is an unscientific treatment and a symbol of authority of the old psychiatry. ECT is not necessary as a treatment modality in the modern practice of psychiatry.
Time to abandon electroconvulsion as a treatment in modern psychiatry. Youssef HA, Youssef FA. Adv Ther 1999 Jan-Feb;16(1):29-38
o Electroconvulsive treatment (ECT) is increasingly used in North America and there are attempts to promote its further use world-wide. However, most controlled studies of efficacy in depression indicate that the treatment is no better than placebo with no positive effect on the rate of suicide.
Electroshock: scientific, ethical, and political issues. Peter R. Breggin. International Journal of Risk & Safety in Medicine 11 (1998) 5-40 IOS Press
o In a double-blind study of four different ECT modalities with depressed patients, 26 out of 90 patients failed to respond to therapy….Forty-one of the 70 who did respond (59 percent) relapsed, and there were no differences between treatment groups.
Effects of stimulus intensity and electrode placement on the efficacy and cognitive effects of electroconvulsive therapy. Sackeim HA, Prudic J, Devanand DP, Kiersky JE, Fitzsimons L, Moody BJ, McElhiney MC, Coleman EA, Settembrino JM. N Engl J Med 1993 Mar 25;328(12):839-46
o A study of two different types of shock therapy conducted at the New York State Psychiatric Institute in New York City, 53% of 80 depressed patients studied relapsed within two months of treatment.
A prospective, randomized, double-blind comparison of bilateral and right unilateral electroconvulsive therapy at different stimulus intensities. Sackeim HA, Prudic J, Devanand DP, Nobler MS, Lisanby SH, Peyser S, Fitzsimons L, Moody BJ, Clark J Arch Gen Psychiatry 2000 May;57(5):425-34
o A more recent study by the same group shows that without active treatment, virtually all remitted patients relapse within 6 months of stopping ECT. The authors are among the leading advocates of ECT.
JAMA 2001 Mar 14;285(10):1299-307. Continuation pharmacotherapy in the prevention of relapse following electroconvulsive therapy: a randomized controlled trial. Sackeim HA, Haskett RF, Mulsant BH, Thase ME, Mann JJ, Pettinati HM, Greenberg RM, Crowe RR, Cooper TB, Prudic J
o "Twenty-eight percent of a group of 42 patients undergoing ECT suffered cardiovascular problems including ischemic and/or arrhythmic complications following treatment. Seventy percent of the patients who had a history, physical or EKG evidence of cardiac disease developed cardiac complications."
The Identification and Management of Patients with a High Risk for Cardiac Arrhythmias During Modified ECT. Joan P Gerring. M.D. and Helen M Shields, M.D. J Clin psychiatry 43 4.
o "ECT-induced seizures cause a rapid rise in blood pressure; at the same time the brain experiences a significant reduction in blood flow."
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 Webb, et al. Cardiovascular response to unilateral ECT Biol Psych 1990;28:758-766 . Rosenberg, et al. Effects of ECT on cerebral blood flow Convulsive Therapy 1988;4:62-73.
o "A Mayo clinic study of 34 elderly patients receiving shock found an 18% incidence of serious heart arrhythmias during treatment; 4 had ventricular tachycardia requiring IV lidocaine, 2 had supraventricular tachycardia requiring IV beta blockers. An additional 2 patients had other cardiogram changes."
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 Tomac, T. and Rummans, T. Safety and Efficacy of Electroconvulsive Therapy in Patients Over Age 85. Am J Geriatr Psych 1997;5:126-130.
o "After his eighth ECT, a 57-year-old man died of heart rupture."
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 Ali, P.B. and Tidmarsh, M.D. Cardiac Rupture During Electroconvulsive Therapy Anesthesia 1997; 52: 884-895.
o "Physicians from Tulane University Medical School reported on a 69-year-old woman who developed brain hemorrhage during ECT. She was also left with epilepsy afterward. This was, as expected, associated with further deterioration in her mental status from her baseline depression. They conclude that the fragile vessels of the elderly may make some patients a particularly high risk for ECT."
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 Weisberg, et al. Intracerebral hemorrhage following ECT. Neurology 1991; Nov: 1849.