February 2007
Monthly Archive
Little merit in ECT, US study finds Wednesday, Feb 7 2007
ECT Information and News and ECT Effects and Statistics and Studies and Patient Info and Informed Consent 11:10 am
Opponents of electric-shock therapy are calling for a ban on its use in the elderly after a new study shows they are at increased risk of permanent brain damage.
The Press (New Zealand)
Feb 7 2007
By KAMALA HAYMAN
The elderly, women and people with lower IQs are the most vulnerable to brain damage, particularly memory loss, according to the first large-scale study on the long-term effects of electroconvulsive therapy (ECT).
About 300 patients a year are given ECT in New Zealand. Two-thirds are women and about 60 per cent are over the age of 50.
In a report released last year, the Health Ministry said ECT was “a valuable and sometimes life-saving” treatment for depression, mania and catatonia, although its effects were typically short-term.
In the New York study, just published in the Neuropsychopharmacology international journal, researchers followed 347 patients for six months.
The research team, led by Harold Sackeim, said the study provided the evidence that “adverse cognitive effects can persist for an extended period and that they characterise routine treatment with ECT”.
The “more severe and persisting” memory problems were found in those given ECT to both sides of the brain, leading the team to conclude there was “little justification” for such treatment.
Some patients were given ECT to only the right side of the brain, to protect the memory centre in the left.
Auckland clinical psychologist John Read said some New Zealand patients were still being given ECT on both sides of the brain.
Read, a long-standing campaigner against the use of ECT, has sent a second petition to the parliamentary health select committee calling for a ban on the treatment in older people, pregnant women and those under 18.
Read said the beneficial effects of ECT were short-term and there was no evidence it saved lives by preventing suicide.
He said patients given ECT should be told: “It does make some people feel better for a short period of time and it causes permanent brain damage for a significant proportion of people.”
A Christchurch 53-year-old, given ECT for severe depression last year, said she had consented to her 12-dose treatment but did not believe it was informed consent as she was not warned of the risk of permanent memory loss. “I have lost my long-term memory and I have lost totally the ability to administer and organise things,” she said.
Despite the “dreadful” side-effects, the woman, who did not want to be named, said ECT was a valuable treatment. Severe depression was not only life-threatening, it was a horrendous experience. “I was like the walking dead.”
She said her depression returned several months after the ECT, although it had since lifted, possibly due to acupuncture and meditation.
Canterbury psychiatric patients are among the most likely in the country to have ECT. In the year to June 2005, 79 Canterbury patients had a course of ECT, about one-quarter of the 307 treated nationally.
Health select committee chairwoman and Green MP Sue Kedgley said ECT was a “barbaric and old-fashioned technique” used in New Zealand with little regulation, monitoring or evaluation. The number of patients given ECT varied wildly in different parts of the country, as did the length of each course.
Kedgley was concerned that one in five patients had ECT without giving consent, and the rate was above 50% in some districts.
“If it is going to cause the harm that this research shows, then I certainly question why it should be given to people without their consent,” she said.
Canterbury psychiatrist Richard Porter, who oversees ECT use, said one-sided (unilateral) ECT was usually prescribed unless treatment was particularly urgent or there was no response to unilateral ECT.
“The choice is discussed with patients and family and the pros and cons explained before the decision is made,” he said. This particularly applied to the elderly, in whom it had been “known for a long time” that memory loss was more likely, he said.
It’s a blog, blog, blog, blog world Friday, Feb 16 2007
Two more blogs you should check out. Go now - these guys may be rogues in their fields. Somehow I’m picturing Jack Sparrow right now, and you can’t beat a mental picture of that!
First up, The Last Psychiatrist. He doesn’t name himself, but does say he’s an academic who specializes in forensics. Hmm. He doesn’t seem to be the “typical” psychiatrist and says things like this:
Psychiatry is politics, it is politics in the way that running for office is politics. It is not a science, it is not even close to science, it is much closer to politics.
No wonder he doesn’t seem to use him name. That kind of statement isn’t likely to earn him new friends in psychiatry. It’s SCIENCE DAMMIT! And if you say anything to the contrary, then you’re…..a SCIENTOLOGIST! (Or if you’re in the ECT Boys’ Club, you’ll drag a label out of the DSM Scrabble bag and fling that instead.)
So check out Dr. Jack Sparrow, The Last Psychiatrist. He’s got a touch of sardonicism, and I’m always a sucker for that.
Next up, Clinical Psychology and Psychiatry, A Closer Look. Start with this article on biased research and then keep reading. He’s got a number of hot buttons and they’re all dandies.
These are two high quality, interesting blogs and if you start reading, I think you’ll have a hard time getting out of your computer chair. I’m not responsible for eye strain.
Two more blogs of note Wednesday, Feb 14 2007
News and Lawsuits and Book/Video Reviews 12:21 pm
MindFreedom.org has a blog and has been documenting the ongoing Eli Lilly legal challenges:
Next blog is from the makers of the film “Side Effects,” and includes news about the pharmaceutical industry. I’ll soon be viewing and reviewing their new film “Money Talks - Profits Before Patient Safety.” The trailer intrigued me and this looks like it could be a dandy!
Eli Lilly, the big bully Wednesday, Feb 7 2007
News and Hall of Shame and Tenet & Other Bad Boys 2:24 pm
As many of you know, a few years ago I battled Tenet Healthcare Corporation in the case of Kathleen Garrett, an elderly woman who was being forcibly shocked at a St. Louis Tenet-owned hospital. They tried to threaten and bully me into silence with threats of lawsuits, etc. I now keep track of Tenet’s bad behavior (and it’s really quite bad) on this website.
It seems that Eli Lilly is using the same tactics, what are called SLAP lawsuits, in their effort to shut activists up about the dangers of the drug Zyprexa. But they’ve actually filed lawsuits against Mindfreedom.org and a number of activists.
Read all about it and spread the word! Find out what Eli Lilly doesn’t want you to know.
http://www.mindfreedom.org/know/psych-drug-corp/eli-lilly-secrets/
Research Investigates Whether Vitamin Folate Helps To Treat Depression Sunday, Feb 4 2007
Self Help 12:21 pm
Medical News Today
Feb 3 2007
New research commissioned by the NIHR Health Technology Assessment (HTA) programme is looking into whether the vitamin folate can help in the treatment of depression. One in five people experience depression during their lives and only half of these people respond to antidepressant treatment.
Folate, a vitamin found in foods such as green vegetables, helps to produce chemicals that regulate brain functions, including mood, sleep and appetite. A Cochrane review concluded that folate may have a role as a supplement to other treatments for depression, but the evidence is limited and primary research is needed to test this.
“Antidepressants work by improving the way certain chemical messengers work in the brain and folate helps produce the chemicals needed for this process,” says Professor Ian Russell of the University of Wales Bangor.
“Low levels of folate from a poor diet or similar factors could worsen depression and stop antidepressants from working optimally.”
Researchers in Wales led by Professor Russell are set to conduct the biggest randomised controlled trial of its kind to test whether a folate tablet taken daily by people with depression will help their antidepressants to work better. In addition to their antidepressants, participants will be given either a folate tablet or a dummy tablet for three months. Researchers will ask them about the effect this has on their depression, and take blood samples to corroborate this.
“We welcome this research initiative into the potential of folate to enhance the effect of anti-depressant medication,” says Lindsay Foyster, Director of Mind Cymru. “If the research proves folate to be efficacious then an easily acquired simple supplement or an informed improvement in diet could make a significant contribution to the self management of depression.”
For more information visit: http://www.hta.ac.uk/project.asp?PjtId=1537
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Notes:
1. The HTA programme produces high quality research information about the effectiveness, costs, and broader impact of health technologies for those who use, manage and provide care in the NHS. This is a programme of the National Institute for Health Research (http://www.nihr.ac.uk) and is the largest and longest running of the national programmes with 340 projects published since its inception in 1993. About 50 are published each year, all available for download free of charge from the website. It is coordinated by the National Coordinating Centre for Health Technology Assessment (NCCHTA), based at the University of Southampton.
Visit http://www.hta.ac.uk for more information.
2. Mind (National Association for Mental Health) is the leading mental health charity in England and Wales and works to create a better life for everyone with experience of mental distress.
Visit http://www.mind.org.uk for more information.
For further information please go to:
National Institute for Health Research And
University of Southampton
When antidepressants don’t work Saturday, Feb 3 2007
Personal Accounts and Book/Video Reviews 12:56 pm
BY JOYCE RUSSELL
Northwest Indiana Times
Feb 3 2007
PORTAGE | Barbara Layton’s depression had become so severe she had only the energy to sit in a rocking chair all day and slowly rock back and forth.
The Hobart native and Portage resident had suffered from depression since she was a teen. At age 21, she attempted suicide. But it wasn’t until she reached 40 that she was diagnosed with bipolar disorder.
Like most with the illnesses, she’d been treated with a cocktail of antidepressants. This time, however, they weren’t working.
Suicide again crossed her mind, but she didn’t have the energy to carry out the thought, Layton said.
Instead, after consulting with doctors and educating herself and family members, Layton agreed to undergo electroconvulsive therapy, or ECT, more commonly known as electro shock treatments.
After six treatments, Layton’s depression had eased sufficiently that she was released from the hospital and returned to her normal life. That was in 1998.
“It scared me to death,” she said of her initial reaction to the recommendation, but she knew she had to do something.
“It saved my life. It just saved my life, and it was quick,” said Layton, 57.
Layton, founder and executive director of the Porter County chapter of the National Alliance on Mental Illness, has been an advocate for the mentally ill for years.
She took it a step further last year by agreeing to be one of a dozen ECT patients portrayed in the book “Shock: The Healing Power of Electroconvulsive Therapy” by Kitty Dukakis, wife of former presidential candidate Michael Dukakis, and Larry Tye. She also was featured in the DVD documentary “Shock,” produced by AMS Production Group. Both are available through Amazon.com.
The reason she agreed to go public on a national level was to continue her efforts to educate people about mental illness, she said. The book, which predominately features Dukakis’ battle with depression and use of ECT, and the DVD both take a look at the pros and cons of ECT.
“I wanted to help fight the stigma. I wanted people to recognize me as me and not as my illness. I am Barbara Layton, not a bipolar,” she said. “I’ve always been vocal about mental illness. There is a lot of stigma attached.”
Layton said her efforts have been to teach others that mental illnesses like hers are not a person’s “fault” and that depression is not something someone can simply “get over.” According to the National Institute of Mental Health, depression is the leading cause of disability for people ages 15 to 44.
ECT, while administered to 100,000 people annual in this country, is misunderstood, Layton said. The stigma behind the use of the treatments comes from the media, especially the portrayal of the therapy in films like “One Flew Over the Cuckoo’s Nest” and “Frances.” The procedures have changed in administering ECT and are depicted in the DVD.
“I’m very pleased with the video. It shows the pros and cons of ECT. If you’re contemplating this, it is a very good source,” she said, adding the video is objective and that stories are about successful and unsuccessful treatments.
“I want people to know it is safe. I want them to go into it (ECT) very educated and look at it long and hard. This is not for someone with a mild case of depression. It is for someone with a debilitating case who has gone through all the medications.”
SEE FOR YOURSELF
The documentary “Shock” featuring Portage resident Barbara Layton is available at Amazon.com for $19.95. The book “Shock: The Healing Power of Electroconvulsive Therapy,” which also features Layton’s battle with depression and use of electro shock treatments, also is available at Amazon.com for $17.22.
Parity for mental illness - Swiss may expand assisted suicide Friday, Feb 2 2007
News 8:21 pm
You wanted parity? Swiss may expand assisted suicide to include mental illness
Yahoo News
Feb 2 2007
A ruling by Switzerland’s highest court released Friday has opened up the possibility that people with serious mental illnesses could be helped by doctors to take their own lives.
Switzerland already allows physician-assisted suicide for terminally ill patients under certain circumstances. The Federal Tribunal’s decision puts mental illnesses on the same level as physical ones.”It must be recognized that an incurable, permanent, serious mental disorder can cause similar suffering as a physical (disorder), making life appear unbearable to the patient in the long term,” the ruling said.
“If the death wish is based on an autonomous decision which takes all circumstances into account, then a mentally ill person can be prescribed sodium-pentobarbital and thereby assisted in suicide,” it added.
Various organizations exist in Switzerland to help people who want to commit suicide, and assisting someone to die is not punishable under Swiss law as long as there is no “selfish motivation” for doing so.
The judges made clear in their ruling that certain conditions would have to be met before a mentally ill person’s request for suicide assistance could be considered justified.
“A distinction has to be made between a death wish which is an expression of a curable, psychiatric disorder and which requires treatment, and (a death wish) which is based on a person of sound judgment’s own well-considered and permanent decision, which must be respected,” they said.
The case was brought by a 53-year old man with serious bipolar affective disorder who asked the tribunal to allow him to acquire a lethal dose of pentobarbital without a doctor’s prescription.
The tribunal ruled against his request, confirming the need for a thorough medical assessment of the patient’s condition.
Whether any Swiss physician would be prepared to prescribe a lethal dose of pentobarbital to a mentally ill person remains unclear. The country’s national ethics commission could not be reached for comment late on Friday.
Switzerland is one of a number of countries in Europe that allow assistance to terminally ill people who wish to die.
Netherlands legalized euthanasia in 2001 and Belgium in 2002, while Britain and France allow terminally ill people to refuse treatment in favor of death.
