ECT Often Associated With Retrograde Memory Loss

ECT Often Associated With Retrograde Memory Loss

Reuters Health Information 2003. © 2003 Reuters Ltd.

NEW YORK (Reuters Health) Jun 20 – About one third of patients report
persistent memory loss after undergoing electroconvulsive therapy (ECT), results of a
meta-analysis suggest, but clinical studies may fail to document this
phenomenon because they do not address retrograde amnesia.

The Royal College of Psychiatrists states that more than 80% of depressed
patients treated with ECT respond well and that this treatment does not cause
persistent memory loss. In the British Medical Journal for June 21, Dr. Diana
Rose and colleagues at the Institute of Psychiatry in London point out that many
patients disagree with the College’s statement.

After searching relevant databases, Dr. Rose and her associates identified 35
reports documenting patients’ views on treatment with ECT. Nine reports were
either undertaken by patients or with the collaboration of patients. Sixteen
evaluated the perceived benefit and seven investigated memory loss at least 6
months after treatment.

Perceived benefit varied widely between studies (p < 0.001), the
investigators found. Studies carried out by clinicians alone tended to report the highest
levels of positive responses; Dr. Rose’s group suggests clinicians’ studies
took place soon after treatment and used fewer questions than did those by
patients.

Persistent memory less was reported by 29% to 55% of subjects. The authors
maintain that the studies on which the Royal College of Psychiatrists based its
findings used routine neuropsychological tests that measure anterograde
memory. “Thus, the risks reported by patients do not appear in clinical
assessments,” they write. They therefore suggest that the College’s statement “that memory
loss is not clinically important is unfounded.”

In an editorial, Drs. Stuart Carney and John Geddes agree that there is a
dearth of “genuinely collaborative high quality research” in this area.

The National Institute for Clinical Excellence (NICE) has conducted an
appraisal of ECT based on a review of the use of this therapy for schizophrenia, the
University of Oxford editorialists point out.

They predict that in the UK, potential overuse of ECT will be avoided because
of the “restrictions, increased safeguards, and improved consent procedures”
recommended by NICE without compromising access to ECT for the most severely
ill patients.

BMJ 2003;326:1343-1344,1363-1365.

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