You will find a great deal of information on electroconvulsive therapy, pro, con and neutral. The site is huge, and I’ve tried to organize articles to make it as easy as possible to find the type of info you seek. Many articles are tagged for more than one category, and you will also find “Possibly Related Articles” at the bottom of each page to expand your search.
The menu at the right has the main categories concerning electroconvulsive therapy. Please note that this site has been online for 15 years, and therefore, some articles will be much older than others.
You may comment on any article without having to register. At this time, comments will be unmoderated. If spammers show up, however, I’ll have to change that.
For more information and discussion about electroconvulsive therapy, you might want to also visit ect.org’s companion site, ZapRap.org, the message forums. At this time, registration is required for most forums.
Added: March 12, 2010 |
The Food and Drug Administration is in charge of regulating medical devices just as it does drugs, including the machines used to give shock treatment. But it’s not doing its job. It has allowed these machines to be used on millions of patients over the past generation without requiring any evidence whatsoever that shock treatment is safe or effective! This is so even though shock machines are Class III—high risk—devices, which by law are supposed to be investigated by clinical trials as thoroughly as new drugs and devices just coming onto the market. But because of intense lobbying by the American Psychiatric Association—which claims the devices are safe but opposes an investigation—the FDA has disregarded its own law. (For the full story of how shock survivors have fought for a scientific safety investigation of ECT for the past 25 years, see the new book Doctors of Deception: What They Don’t Want You to Know About Shock Treatment by Linda Andre.) Read the rest of this entry »
Added: September 22, 2009 |
If you buy and read only one book on ECT, this should be the one. Andre is not only a survivor of ECT, but has spent the past 25 years listening to, and documenting the experiences of, other survivors. With her exhaustive knowledge of what passes for scientific research on the subject, and an insider’s knowledge of the politics behind that “science” as well as the pronouncements of supposedly trustworthy authorities like the FDA, no one is more qualified to demolish the claims of the shock industry. Andre does so with thoroughness, style, and even wit. Everything she says is documented, but never before has all this information been gathered in one volume.
Read the rest of this entry »
Added: April 7, 2009 |
We’re a little late inducting Dev, so let’s call him the 2007 Honoree, because the 2008 Honoree is right behind him in line, to be announced soon!
Psychiatrist Davangere Devanand of Columbia University is dis-honored for his two faces: shock doctor and author of “The Memory Program,” a book on how to maintain and improve memory! Read the rest of this entry »
Added: April 23, 2008 |
“When science has a commercial basis, those who make a living out of one point of view seem much less likely to tolerate dissent than is normal in the rest of science.”
(David Healy, from his 2004 book Let Them Eat Prozac)
Once, just once, it would be nice to see doctors who use ECT make an argument for their product based on facts and science, without lies and omission, without making stereotypical errors of reasoning, and without lowering themselves to the level of libel by disparaging the sanity and veracity of their former patients. Read the rest of this entry »
Added: April 23, 2008 |
CVMC seeks OK for shock therapy
November 5, 2007
By Mel Huff Times Argus Staff
BERLIN – Central Vermont Medical Center is seeking state approval to provide electroconvulsive therapy to a small number of psychiatric patients so they can receive treatment closer to home.
“On the average, CVMC has been treating six to 12 patients a year who are subsequently sent to Dartmouth or Fletcher Allen for electroconvulsive therapy, so the ability to have this in the community is important,” said Dr. Peter Thomashow, CVMC’s medical director of inpatient psychiatry.
Once referred to as electroshock, the treatment now called ECT has changed substantially and been refined since it was first introduced in the early 1940s.
“Generally, this is a treatment reserved for patients with severe depression, depression with psychotic features and sometimes for very agitated depressions. It is rarely used first-line,” Thomashow said, explaining that in most cases psychiatrists turn to it only after drug therapy has proven unsuccessful or in situations where the depression is life-threatening.
No patients from Vermont State Hospital or the Vermont Department of Corrections will be treated if approval is granted for CVMC, Thomashow said.
Thomashow cited “lethal catatonia” as an example of a life-threatening condition where electroconvulsive therapy might be used as a first-line treatment. “Someone in severe catatonia can be so impaired that they don’t eat or drink, they don’t move,” he said. “ECT is the most effective treatment for this kind of catatonia.”
All patients who come to the unit for care will get a comprehensive screening, including “a full battery of blood tests to rule out any possible medical causes for their depression. Sometimes, patients will get a CT scan or an MRI of the brain to rule out any medical condition such as a brain tumor that could cause their depression,” he said.
For many, the public image of ECT comes from the movie of Ken Kesey’s “One Flew Over the Cuckoo’s Nest,” in which actor Jack Nicholson undergoes the process. But both the equipment and the sophistication of its use have changed considerably.
Thomashow and the other two psychiatrists at CVMC, Dr. Kenneth Adler and Dr. Paul Cameron, had a weeklong fellowship at Columbia University School of Medicine, where much of the research in ultra-brief unilateral electroconvulsive therapy – the kind that CVMC plans to use – has been done. The nursing staff has also gone through training.
“The ultra-brief unilateral ETC is a fairly recent development,” Thomashow said, explaining that the machine CVMC purchased is able to deliver stimulus to just one side of the brain, which “has far less side effects and is much better tolerated than bilateral (both sides of the brain) ETC.”
Jim Tautfest, the nurse director of inpatient psychiatry, noted that the new machines can be adjusted to a variety of pulse-widths, frequencies and durations of stimulus. This flexibility enables the psychiatrist to provide effective treatment with fewer side effects.
The most common side effect is short-term, and in some cases also long-term, memory loss. The degree of memory loss is the subject of substantial debate.
The decision to use electroconvulsive therapy will be made by a treatment team, Thomashow said, and will include extensive records reviews, consultation with the primary care physician and interviews with the patient and his family, along with a full medical work-up.
With a patient who presents special concerns, Thomashow said, tests will be done to determine if electroconvulsive therapy will work or pose problems. Elderly patients will get cardiograms, and patients over 50 will get chest X-rays. A patient who has had a recent heart attack would not receive electroconvulsive therapy, Thomashow noted.
He added that “there’s a very detailed informed consent process that is supervised by the state of Vermont. There’s quite a lot of oversight and regulation.” Patients and families will be shown an informational videotape produced by Dartmouth Hitchcock Medical Center and will discuss the risks and benefits of electroconvulsive therapy before consenting to the treatment.
“There’s no question that it’s a very effective treatment in the right individual,” Thomashow said, offering benefits to some “individuals who have suffered for prolonged periods of time, whose lives have changed and who have not been able to function.”
CVMC’s application is the first the Department of Mental Health will act on since the Legislature charged it in 2000 with oversight. Fletcher Allen Health Care, White River Junction VA Medical Center and Retreat Healthcare in Brattleboro are already providing ECT.
Dr. Bill McMains, the medical director of the Department of Mental Health, said officials will conduct a review to make sure that the hospital’s standards for ECT comply with national standards, as well as meet extra state requirements to ensure “the safety of the person and making sure that people are adequately educated about what they’re doing.”
Vermont has “a very in-depth consent form” that hospitals must agree to use in order to get certified, he added. The form was developed through two years of negotiations with treatment experts and hospitals that were delivering electroconvulsive therapy at the time. McMains noted that Rep. Anne Donahue, R-Northfield, who follows mental health issues closes, was “very much a party” to developing the document.
The form, which all Vermont hospitals must use, requires that hospitals obtain the patient’s consent after every 12 treatments. “So a person doesn’t give ‘forever’ consent,” McMains observed. “It’s only good for 12 treatments, and then you have to go over it and get consent for any more.”
Added: December 14, 2007 |
Today Israel remembers the Holocaust and honors those who died and survived.
I suggest each person who visits ect.org today take a few moments to learn more about the Holocaust and why the need exists for reminders that it happened.
Many of you visiting, had you lived under the Nazis, would have likely been exterminated too. You (and I) would have been part of the mentally defectives, the less desirables. Most people don’t know that along with six million Jews, a number of Gypsies, homosexuals and other groups considered to be “less than,” mental defectives – persons with mental illness, epilepsy and mental retardation – were systematically exterminated to cleanse the race.
Nearly a quarter million mental defectives died at the hands of the Nazi eugencis program.
The effect of the principles at work here that children call each other names and say “you’re crazy; you’ll be sent to the baking oven in Hadamar”…
…Letter from Dr. Hilfrich, Bishop of Limburg, to the Reich Minister of Justice, August 13, 1941 (Trials of War Criminals Before the Nuernberg Military Tribunals – Washington, U.S Govt. Print. Off., 1949-1953, Vol. I, p. 845-846).
I remember my birthday when I was living in the Soviet Union shortly before it fell apart and visited Kiev. Because it was my birthday, I was given the honor of placing flowers at the memorial of Babi Yar, just outside the city. Babi Yar is the site of yet another massacre by the Nazis, where approximately 100,000 Soviet civilians – many of them Jews – were rounded up over a period of two days and executed.
The first to die were the 700 patients of a psychiatric hospital.
I urge you to visit a photographic tour from several years ago by a small group of psychiatric survivors. The “Freedom from Fear Tour” explores the history of the extermination of “mental defectives” under the Nazis.
Freedom From Fear
Other sites worth visiting:
Yom Ha’Shoah blog roundup
Holocaust Museum in Washington, DC
Deadly Medicine: Creating the Master Race, a new exhibit at the Centers for Disease Control in Atlanta
I leave you with the poem Babi Yar by one of my favorite poets of all time, Yevgeny Yevtushenko.
Babi Yar by Yevgeny Yevtushenko
No monument stands over Babi Yar.
A drop sheer as a crude gravestone.
I am afraid.
Today I am as old in years
as all the Jewish people.
Now I seem to be
Here I plod through ancient Egypt.
Here I perish crucified, on the cross,
and to this day I bear the scars of nails.
I seem to be
is both informer and judge.
I am behind bars.
Beset on every side.
Squealing, dainty ladies in flounced Brussels lace
stick their parasols into my face.
I seem to be then
a young boy in Byelostok.
Blood runs, spilling over the floors.
The barroom rabble-rousers
give off a stench of vodka and onion.
A boot kicks me aside, helpless.
In vain I plead with these pogrom bullies.
While they jeer and shout,
“Beat the Yids. Save Russia!”
some grain-marketeer beats up my mother.
0 my Russian people!
are international to the core.
But those with unclean hands
have often made a jingle of your purest name.
I know the goodness of my land.
How vile these anti-Semites-
without a qualm
they pompously called themselves
the Union of the Russian People!
I seem to be
as a branch in April.
And I love.
And have no need of phrases.
is that we gaze into each other.
How little we can see
We are denied the leaves,
we are denied the sky.
Yet we can do so much –
embrace each other in a darkened room.
They’re coming here?
Be not afraid. Those are the booming
sounds of spring:
spring is coming here.
Come then to me.
Quick, give me your lips.
Are they smashing down the door?
No, it’s the ice breaking …
The wild grasses rustle over Babi Yar.
The trees look ominous,
Here all things scream silently,
and, baring my head,
slowly I feel myself
And I myself
am one massive, soundless scream
above the thousand thousand buried here.
each old man
here shot dead.
here shot dead.
Nothing in me
shall ever forget!
The “Internationale,” let it
when the last anti-Semite on earth
is buried forever.
In my blood there is no Jewish blood.
In their callous rage, all anti-Semites
must hate me now as a Jew.
Added: April 16, 2007 |
Linda Andre’s new book scheduled for 2008 publication
If you visit ect.org next year, expect that I’ll be promoting Linda Andre’s new book! And you’d better plan on buying.
Her book was purchased this week by a major publisher!
This book will shed light on an industry that has fed on a plague of self deception, of defensiveness, and of outright lies. Might as well put the shock industry on official notice: the chipping away at your ivory wall continues. This time, Ms. Linda Andre will be wielding a jackhammer.
I confess I’ve had a peek, and the writing is stunning. That’s not a surprise to me and won’t be to anyone who knows Linda’s skills. It may be a surprise to the “gang” (Sackeim, Ricky and friends), who won’t be able to conceive that she’s far more articulate than they are.
This book will illuminate the practices of an industry the way that my favorite book “And The Band Played On” by Randy Shilts did regarding the AIDs epidemic and the Reagan Administration’s failure to react. In a year’s time, Shilt’s book will have to accept its role as “second-favorite” book.
Please check back in a year, or head to your favorite bookstore to purchase Linda Andre’s upcoming book.
Added: March 11, 2007 |
Senator and statesman, Thomas Eagleton dies at 77
By Jo Mannies
POST-DISPATCH POLITICAL CORRESPONDENT
Sunday, Mar. 04 2007
Retired U.S. Sen. Thomas F. Eagleton — a towering figure in national and state politics for half a century and the person for whom the federal courthouse downtown is named — died late Sunday morning.
He was 77. He had been ill for several months with various health problems. He died at St. Mary’s Health Center in Richmond Heights.
Colorful, blunt and candid, with a booming voice and ready recall of history, Sen. Eagleton exuded the aura of the statesman that adversaries and admirers agreed he had become.
At a time of polarizing partisanship, Sen. Eagleton was proud of his friendships across the aisle, notably with former Sen. John C. Danforth, R-Mo., who served 10 years in the Senate with Sen. Eagleton.
Nationally, Sen. Eagleton, an early opponent of the U.S. role in the Vietnam War, made his mark as chief author of the federal War Powers Act, which limited the authority of the president to wage war without congressional approval.
He was known also for his brief stint in 1972 as the running mate of Democratic presidential nominee George McGovern. Sen. Eagleton was forced to step down when his electric shock treatments for depression in the 1960s became public.
Since 1997, McGovern has stated publicly several times that he made a mistake and should have kept Sen. Eagleton on the ticket.
In Missouri, Sen. Eagleton never lost an election, beginning with his victory in 1956, at age 27, for St. Louis circuit attorney. Within 12 years, he also won statewide contests for attorney general, lieutenant governor and U.S. Senate.
After serving 18 years and a few days in the Senate, Sen. Eagleton retired in January 1987 and declared that — while only 57 — he©ˆd never run for public office again.
He kept that pledge but continued to wield tremendous clout in state and regional politics and civic affairs.
In 1995, Sen. Eagleton was the public point man for the bipartisan political and business effort that wooed the Rams football team from the West Coast to St. Louis.
Even Sen. Eagleton was stunned by the local accolades, with football enthusiasts collaring him on the street, especially after the Rams won the Super Bowl in 2000.
St. Louis also may never live down the senator’s witty description he used to sway the Rams’ owners. Asked about the region©ˆs nightlife, Sen. Eagleton quipped, “We’re like a raucous Des Moines.”
Sen. Eagleton also wrote at least 50 commentaries for the Post-Dispatch, in which he often was critical of whoever was in the White House. He was a staunch opponent of the war in Iraq, in line with his outspoken criticism of the Vietnam War in the 1960s and ’70s.
In one of his last commentaries, published Nov. 3, 2005, Sen. Eagleton bluntly laid out what he viewed as the no-win situation facing the United States because of what he viewed as President George W. Bush’s “misadventures” in Iraq.
“Hubris is always the sword upon which the mighty have fallen,” the former senator wrote. “From here on, any president will have to level with the American people before going to war.”
Throughout his career, Sen. Eagleton was a strong supporter of labor and took a liberal stance on many social issues. The notable exception was his vigorous, lifelong opposition to abortion, and his criticism while in the Senate of court-ordered busing to desegregate schools.
He played a major role in the creation of the National Institute on Aging and in congressional action in the 1970s that allowed home rule and limited self-government for the District of Columbia.
His one failed quest was his desire, mentioned often and only partly in jest, to become the commissioner for Major League Baseball.
Politics in his blood
Thomas Francis Eagleton was born in St. Louis on Sept. 4, 1929, to Zitta and Mark D. Eagleton. His father later became one of the city’s most prominent civil trial lawyers.
A bright kid, Tom Eagleton was an honors student in school. He graduated from Country Day School in Ladue and, after a year in the Navy, earned a bachelor’s degree from Amherst (Mass.) College in 1950 and a law degree from Harvard in 1953.
In 1956, he married the former Barbara Ann Smith, daughter of a former paper company executive. The couple had two children: a son, Terence, and a daughter, Christin.
Sen. Eagleton once recalled that he had caught the “political bug” as a child, when his father was elected to the St. Louis School Board in the late 1930s.
When Sen. Eagleton began his political career in 1956, he was the youngest man in St. Louis history to be elected circuit attorney. That record still stands. His Catholic faith became an issue in 1960, when he waged a successful campaign for Missouri attorney general on the same ticket as a fellow Catholic who was the Democratic nominee for president, John F. Kennedy. Crosses were painted on Sen. Eagleton’s election posters in the Bootheel.
After one term as attorney general, Sen. Eagleton opted to run for lieutenant governor in 1964. He won but often quipped later that the state’s No. 2 post was really only good for standing at the window and “watching the Missouri River flow by.”
In 1968, he challenged incumbent Sen. Edward V. Long, a fellow Democrat, in a free-spending primary race in which True Davis, a millionaire banker from St. Joseph, was also a major contender. Sen. Eagleton won the primary and then went on to defeat U.S. Rep. Thomas B. Curtis, a Republican from St. Louis County.
Sen. Eagleton’s campaign platform took aim at the conflict overseas that his party’s presidents had launched. “The very first priority for any candidate for United States senator must be to help find a peaceful and honorable solution to the Vietnam War,” he wrote.
1972 — peak and valley
True Davis later apologized to Sen. Eagleton for being the source of national columnist Jack Anderson’s unsubstantiated stories that Sen. Eagleton had been charged with drunken driving. No proof was ever furnished, and Anderson later apologized.
The nastiness of that 1968 primary campaign carried over into the presidential race in 1972. That year, what should have been the peak of Sen. Eagleton’s career, spiraled into its lowest point. Sen. Eagleton became McGovern’s choice as his vice presidential running mate after Sen. Edward M. Kennedy, D-Mass., publicly declined.
McGovern turned to Sen. Eagleton, both said at the time, because of their common views against the Vietnam War. Both also cited their mutual concern about the nation’s troubled urban areas, many of which had been crippled by race riots, and the already looming problem of lack of access to health care.
McGovern did not know that Sen. Eagleton had been voluntarily hospitalized for nervous exhaustion in 1960, 1964 and 1966 and had undergone electric shock treatment on two of those occasions.
Sen. Eagleton said that before McGovern picked him, he had been asked whether he had any “skeletons in the closet.” In an interview years later, Sen. Eagleton said that he had replied that he had no such “skeletons” because he had not considered his treatments to be in that category. He turned out to be wrong, as far as the McGovern camp was concerned.
Six days after the treatments became public, Sen. Eagleton stepped down. (McGovern ended up with Sargent Shriver as a running mate, and suffered a landslide election loss to incumbent Richard Nixon.)
The episode generated considerable sympathy for Sen. Eagleton back home in Missouri. He arrived to a tumultuous welcome at Lambert Field and handily won re-election in 1974 in a landslide over Curtis.
In 1980, Sen. Eagleton also won re-election — this time over St. Louis County Executive Gene McNary. But his victory was narrow, coming amid a national Republican landslide that carried Republican Ronald Reagan into the White House and swept aside many of Sen. Eagleton©ˆs longtime Democratic colleagues in the Senate.
That 1980 contest also produced another embarrassingly public personal episode involving the senator’s niece, Elizabeth Eagleton Weigand, the daughter of Sen. Eagleton’s brother, the late Dr. Mark D. Eagleton Jr. Sen. Eagleton held a news conference to disclose that Miss Weigand had tried to force him to pay her $220,000 for her minority interest in a family business. She threatened to make public false assertions about his personal life if he refused.
Weigand and her attorney, Stephen E. Poludniak, were convicted of the scheme shortly before the election.
After winning re-election, Sen. Eagleton spent his final term in the Senate focusing on local issues while strengthening his personal and professional ties with Danforth.
Among other things, Sen. Eagleton used his considerable clout to obtain federal money to rebuild Highway 40©ˆs Vandeventer Overpass and to connect Interstate 170 to Interstate 270. Sen. Eagleton also joined with Danforth to kill the long-authorized federal Meramec Lake and Dam project in the early 1980s, after Missouri voters had overwhelmingly rejected the plan in an advisory referendum in 1978. Sen. Eagleton earlier had supported the dam.
In announcing his plans to retire from office in 1986, Sen. Eagleton acknowledged to reporters that his lifelong love of baseball made him seriously consider applying for the then-open job of commissioner of baseball.
But he did not apply, he explained, because he wouldn’t resign his Senate seat while a Republican was governor, which was the case during most of the 1980s. Sen. Eagleton said that meant that a Republican would be appointed to replace him, and he couldn©ˆt stomach the thought.
During his final term, Sen. Eagleton was among the first voices in Congress to criticize President Ronald Reagan’s foreign and economic policies, and one of the few in the Senate to oppose Reagan©ˆs tax cuts, arguing that they were too deep.
During a speech in rural Missouri, Sen. Eagleton argued that the cuts would wrongly benefit wealthy Missourians like himself while hurting those who needed the government’s help.
“What manner of people are these who cut educational programs and at the same time push through tax credits for people who send their children to Andover, Exeter, Mary Institute, Country Day and John Burroughs?” asked Sen. Eagleton, himself a Country Day graduate.
“Once again, once again,” he roared with his booming baritone, “largesse to the rich!”
Stumping for Carnahan
During his retirement, Sen. Eagleton practiced law and became a favorite speaker at Democratic rallies. But he also joined with Danforth at several speaking events, where the duo made their case for more civility in politics.
Occasionally, Sen. Eagleton would resurrect his razor-sharp partisan skills. After the plane crash on Oct. 16, 2000, that killed the Missouri Democratic nominee for the U.S. Senate — then-Gov. Mel Carnahan — it was Sen. Eagleton who held a news conference to quell growing Republican claims that it would be illegal for a deceased candidate to remain on the November ballot.
Sen. Eagleton bluntly jabbed at Republican incumbent John Ashcroft by declaring, “A U.S. senator who can©ˆt beat a dead man doesn©ˆt belong in the U.S. Senate.”
Sen. Eagleton’s rhetoric touched off Republican outrage but helped re-energize his party and became the most-quoted comment of the campaign. Carnahan went on to become the first candidate in U.S. history to be elected posthumously to the U.S. Senate. Last year, even while battling some health problems, Sen. Eagleton campaigned for Amendment 2, the ballot initiative to protect all forms of stem cell research allowed under federal law. Sen. Eagleton was the campaign’s honorary co-chairman along with Danforth, his old Republican friend.
Eagleton is survived by this wife Barbara, his two children and three grandchildren.
Services for Eagleton will be on Saturday at Saint Francis Xavier College Church, 3628 Lindell Blvd., St. Louis.
Added: March 4, 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.
Added: February 16, 2007 |
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!
Added: February 14, 2007 |
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.
Added: February 7, 2007 |
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.
Added: February 7, 2007 |
You wanted parity? Swiss may expand assisted suicide to include mental illness
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.
Added: February 2, 2007 |
FDA Advisory Panel Sees Marginal Effect of TMS in Depression Treatment
By Todd Zwillich
WebMD Medical News Reviewed By Louise Chang, MD
January 29, 2007
Jan. 29, 2007 — An FDA advisory panel on Friday questioned the value of a new brain stimulation device for depressiondepression, potentially damaging its chances for FDA approval.
Members of the panel expressed doubts that the machine, called NeuroStar, helps depressed patients or provides any advantage over placebo treatment.
The device looks much like a dentist’s chair with metal prongs attached to a nearby console.
It works on the same principle as electroconvulsive therapy (ECT) — commonly called “electric shock treatment” — a treatment usually reserved for severely depressed patients who do not respond to antidepressant drugs or therapy.
But instead of using electric shocks, NeuroStar stimulates the brain by sending a focused magnetic field into the brain from outside the skull — a treatment called transcranial magnetic stimulation, or TMS.
In 2005, the FDA approved an implantable nerve stimulation device made by Cyberonics to treat depression.
The implantable device uses vagus nerve stimulation, or VNS, to stimulate the vagus nerve (which runs from the neck to the brain and relays messages to the brain) rather than the brain directly. VNS is already used to treat epilepsyepilepsy.
Neuronetics, the company that manufactures NeuroStar, presented TMS as an advantage to implantable devices because it does not require invasive surgery.
The company sought to show that the device is equivalent to ECT but with fewer side effects and is more accessible to patients.
“Many patients cannot avail themselves of (ECT) … cannot afford this treatment,” says Philip G. Janicak, MD, a researcher who conducted clinical trials of TMS for the company.
Also, “Only 8% of psychiatrists provide electroconvulsive treatment,” says Janicak, a professor of psychiatry at Rush Presbyterian Medical Center in Chicago.
But the advisory panel was generally unimpressed with the company’s studies, even though they showed a slight statistical advantage in treating depressiondepression symptoms vs. dummy therapy after six weeks of treatment.
Several panelists expressed dismay that patients showed no improvement on some depression scales and only minor improvement on the ones that did show a difference.
“Perhaps a reasonable person could question whether there has been an effect at all,” says Thomas G. Brott, a neurologist from Mayo Medical School in Jacksonville, Fla., and the advisory panel’s chairman.
The panel did not formally recommend to the FDA whether or not the machine should be approved.
But FDA scientists suggested at a public hearing that they were also uneasy with the company’s results.
Ann Costello, PhD, an FDA medical official, questioned whether the mixed evidence of effectiveness in Neuronetics’ studies contained “any clinical relevant information.”
Patients who used TMS appeared to avoid the memory loss often seen in those who undergo ECT.
But Diana Zuckerman, PhD, president of the National Research Center for Women and Families, told the panel the company’s studies did not show the device could help patients.
“It’s not a statistically significant difference, and it’s not a meaningful difference,” says Zuckerman, a clinical psychologist and epidemiologist. “Yes, it is safer than ECT, but it doesn’t appear to actually work.”
Steve Newman, executive director of the National Alliance for the Mentally Ill’s Washington, D.C., chapter, was one of a few patients from Neuronetics’ studies who told experts his deep depression eased after being treated with the machine.
“It was like a light switched on,” he says.
Added: January 30, 2007 |