WINNER: Richard Abrams

Untitled-4.jpgRichard Abrams is the king of self promotion and conflict of interest. His grimy hands are dipped in every pot of electric gold he can find. Not only has he written *the* textbook on ECT (Electroconvulsive Therapy by Oxford Press, 1997), he co-owns Somatics, Inc., manufacturer of the ThymatronTM, the hottest new product in brain assault. And if that isn’t enough, Abrams’ company also manufactures the mouth guard to prevent dental injury during ECT.

When a doctor wrote in the medical journal Convulsive Therapy that doctors could save money by using sports mouth guards instead of more expensive ones, Abrams’ Somatics partner wrote a letter attacking the idea. He didn’t bother to mention that he and Abrams owned the company that manufactured the alternative (at $29 each!)

Some believe that Abrams suffers from multiple personality disorder because of his differing looks. (The above picture is from his blond permed period) I prefer to think that he simply has bad hair days. Thanks to my good friend Jean F. who has provided me with more laughter on this particular concept. Her monologues on Abrams’ varying hairdos are worth more than a year’s supply of Prozac!

Abrams’ text, considered the authoritative work on ECT, subtly promotes his ThymatronTM by pointing out the advantages of an audible system of monitoring induced seizures, over the old fashioned method of chart and pen. And of course the ThymatronTM has it!

thym.jpgHe sells all kinds of gadgets, courses and anything related to ECT: machines, mouth guards, books and videos. He’s the King of ECT! I’m looking forward to the infomercial and the Home ThymatronTM, soon to be seen on the Home Shopping Network.

Abrams will continue to promote ECT over any other method of treatment until the day he dies. In fact, he even says that no progress has been made in the pharmacological treatment of depression since the 1950s. He wrote the following statement in 1992, well after the successful introduction of Prozac and a host of other new antidepressants:

“…despite manufacturers’ claims, no significant progress in the pharmacological treatment of depression has occurred since the introduction of imipramine in 1958.”

Somatics, Inc. Links:
Isn’t it time to upgrade to a Thymatron? – Abrams goes on the offensive and compares his machine to Mecta’s.

Addendum: Here’s an interesting Letter to the Editor from Conrad Schwartz, Abrams’ business partner in Somatics. Conrad and Richard sieze any opportunity they can to diss the competition, Mecta:

Am J Psychiatry 158:973-974, June 2001

Letter to the Editor

ECT Failure Rate Among Specific Devices

CONRAD M. SWARTZ, PH.D., M.D.
Springfield, Ill.
To the Editor: In reporting that adequate ECT seizures were not obtained at the maximum electrical stimulus dose in 5% of ECT patients, Andrew D. Krystal, M.D., M.S., et al. (1) did not recognize that this result is limited to the MECTA Corporation ECT device they used. Instead, they suggested that their results apply to all devices: “Approximately one of six patients…required the maximum possible ECT stimulus intensity available on U.S. ECT devices” (p. 965). The result is limited to MECTA devices because the pulse width and frequency of the maximum stimulus they use are specific to MECTA devices, and their values are crucial to the reported study. These values are for a 2.0-msec pulse width and a 90-Hz frequency with a 2.0-sec duration and 0.8 A current. Compared to these values, the combination of a narrower pulse width, lower frequency, and longer duration should produce lower rates of failure for seizure induction (2, 3). The point that a 5% failure rate is needlessly high is indisputable. However, the failure rate should be substantially lower with more efficient electrical stimuli as well as with higher doses.

Dr. Krystal et al. repeatedly noted a “maximum stimulus intensity limitation of 576 millicoulombs (mC) imposed on U.S. ECT devices by the Food and Drug Administration (FDA)” (p. 963). The actual limitation is 100 J of energy at 220 {Omega} of impedance. For 0.8 A current, as used in MECTA devices, this limitation corresponds to 572 mC. The original source for a figure of 576 mC is MECTA’s commercial literature. I also wish to point out that nowhere in their published article do Dr. Krystal et al. note their relationship with MECTA Corporation.

Footnotes

The author is a member/manager of Somatics LLC, a maker of ECT instruments.

References

  1. Krystal AD, Dean MD, Weiner RD, Tramontozzi LA III, Connor KM, Lindahl VH, Massie RW: ECT stimulus intensity: are present ECT devices too limited? Am J Psychiatry 2000; 157:963–967[Abstract/Free Full Text]
  2. Swartz CM, Larson G: ECT stimulus duration and its efficacy. Ann Clin Psychiatry 1989; 1:147–152
  3. Swartz CM, Manly DT: Efficiency of the stimulus characteristics of ECT. Am J Psychiatry 2000; 157:1504–1506

Comments (2)

Larry MillerMay 26th, 2008 at 12:38 pm

i want to meet dr. andrew d. krystal,conrad swartz and dr richard abrams. i understand people rail against their work.
why? I want to know about black people and forced electroshock.
i want to publicly talk about my findings.keep me on your mailing list. i hope you can provide me with contatc information for the names i’ve asked about. thanks.

Larry MillerMay 26th, 2008 at 12:38 pm

again,thanks.

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