Little merit in ECT, US study finds

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.

Comments (30)

sylviaSeptember 3rd, 2007 at 10:01 pm

i had ect 13 years ago i have short term memory and am disabled permanently in other words its brain damage i am still depressed and take several meds this was the biggest mistake in my life i am worthless in many ways i dont even remember my daughters child hood

ChristineSeptember 25th, 2007 at 1:12 pm

I’m 35 years old and have had over 300 ECT treatments in the past five years. I have short-term and long-term memory problems. I still think ECT was worth it to me to save my life. I stopped maintenance treatments four months ago and am hoping some of my memories will come back and that my short-term memory will improve as well.

Dianna PalmerSeptember 25th, 2007 at 6:02 pm

Hi my name is Dianna Palmer and i was reading some comments up above. I had 13 ect too and still have problems rembering about the past.It really brothers me alot.I hate it.Is there any thing I can do.I was only 13 teen years old.at the time.

BenNovember 3rd, 2007 at 2:08 pm

I had ECT treatments 5-6 years ago and I feel it was the worst decison of my life. It did nothing for me- It caused memory loss and cognitive dysfunctioning. The wanted outcome by psychiatrist I believe- To instill fear and terror and dumb you down. The fear and terror came for me realizing the damage that had been done many months down the road. Don’t be psychiatries whore. Take personal responsabilty and search out others ways to heal your emotional scars. There are no quick fixes. Magic pills and sending enough electricty through your brain that could kill you if it was not contained to your brain is not the answer. WAKE UP !!!!!

eric yNovember 5th, 2007 at 7:40 pm

sammie has been studying ect with fervor and greatly appreciates your comments, especially those from you wo have had treatments. while scientific evidence that jay whitlow has presented is indeterminate whitlow believe the personal stories speak for themselves. However, jay whitlow and eric y state, that regardless of any positive effects, it still seems cruel to be giving treatments to the elderly, those who are already experiencing memory issues. jay whitlow would like to hear more about this. whitlow is especially interested if there are any testimonials reporting positive results from ect with the elderly.
eric y and jay whitlow

LisaNovember 6th, 2007 at 2:07 pm

I’m sorry that some of these people have had such a bad experirence with ECT. I’ve had around 125 ECT’s, and it is the only reason that I am still alive. I’ve tried almost every medication, therapy, acupuncture, and massage therapy that I could get my hands on for Bipolar Disorder. ECT has been the most effective! Yes, there are side effects, like memory loss, thinking problems, headaches, etc. However, I have found that with the right anesthesiologist, some of these can be reduced, if not completely negated. I hope there are other people out there that take advantage of this, and reduce there suffering!

PatsyNovember 11th, 2007 at 11:31 pm

It’s so sad to read some of these stories. I’ve had three rounds of ECT, with four to five treatments in each round. I experience memory problems soon after each treatment, and I always lose the memory of the day before each treatment. I’m on four psych meds, and I would like to get off of them because of the side effects. My plan is to gradually discontinue the psych meds and replace them with monthly maintenance ECT treatments. I get the Ultra Brief Unilateral ECT treatments, which have fewer side effects than traditional ECT. I recommend the Ultra Brief Unilateral ECT treatments, but only for those people who have no doubt that they really need it. If you can control your depression using meds, then don’t take a chance on ECT because the risks are too great. If you have doubts about whether to have ECT, then don’t have ECT. But if you have no doubt that you indeed do need ECT, and if your psych meds aren’t helping, then find a doctor who is willing to give you the Ultra Brief Unilateral ECT. They give this treatment at the University of Minnesota Fairview Riverside Hospital. Good luck.

BenNovember 19th, 2007 at 10:01 am

I often think about the similarities between shock treatment and a concussion-blow to the head. I would imagine a person wouldn’t be thinking about there depression if they were asked questions about this any time soon after receiving either one. Of course this would make perfect sense in relation to maintenance treatments. Would make sense to me why after receiving these treatments- later on down the road the depression just returns. I guess if someone wants to pay for someone to give them a concussion and at the same time do endless brain damage – IT is there choice or is it? I would imagine doctors took somthing called the HYPOCRATIC OATH. IT seems to me psychiatrist are in direct violation of this OATH every time they intentionally, knowingly damage someones brain.

JasonDecember 23rd, 2007 at 1:04 am

I’ve suffered from depression all my life…took prozac many, many years ago…before all the bad publicity…and had a psychotic reaction from it and never touched psyche meds since then…and have suffered untreated ever since. I was considering ECT after seeing this vid: http://www.ted.com/index.php/talks/view/id/189

However, having read some of your comments, I’m having second thoughts. I can’t help but wonder if some of the negative side effects some people are reporting are actually from the powerful drugs the anesthesiologists use when knocking people out. I had surgery some years ago and when I awoke from the drugs, I felt very, very confused, groggy, ‘out of it’ and took a long time in the recovery room to get my bearings enough to go home. Then I had a follow up surgery about a month later…I complained beforehand about my experience and either I had a different anesthesiologist or they used a different drug cocktail, but when I woke up, I felt ‘great’ and clear-headed and actually left the hospital and had lunch with a relative.

So…not sure if the ECT is partially or completely to blame for people’s memory problems and such…but the anesthesiology drugs is an angle people should also look at…the could have long term effects if people are getting them dozens of times over a short period…

Peace

JoelJanuary 14th, 2008 at 2:07 pm

I have had three courses of ECT over the past 25 years and I can say that I know for certain that ECT saved my life. I do not believe in ECT without consent, but I also don’t want this life-saving treatment deamed illegal simply because not everyone has enjoyed the success that ECT can provide in recovering from a psychiatric illness.

debbieJanuary 22nd, 2008 at 8:14 pm

i had ect after 3 suicide attempts and 12 yrs of depression tried all meds no change 2005 i had 8 ect’s and i am so happy i did it It WORKS there is a small memory loss that came back after a yr

KatherineFebruary 13th, 2008 at 2:57 pm

I was given ECT as a teenager upon the recommendation of a psychiatrist who totally missed the mark. I was the product of alcoholic and abusive parents. Rather than seek treatment for their disorders, they chose to ‘dumb me down’ by sending me for ECT. It is one of the most terrifying parts of my past. I am not sure I will ever get over it but I do thank God that I can still function with minimal side effects. I feel ECT is barbaric and should be banned forever.

MargaretMarch 21st, 2008 at 1:43 am

I agee with the above comments
I think ECT is brutal and should be banned completely and help, kindness and the talking therapies used in it’s place. Psychiatrists are on a level with the Inquisiters in the 15th to 17th centuries Then there was a war on people suspected of being witches, now it is a war on people suspected of being mentally ill This is all made up, the same as witchcraft It is time everyone woke up to the falsehood of this psydo-science I know because it was given to me wihout my consent as a teen ager 42+ times and I have also read many good books about the damage Electro Shock Torture causes

carolynMay 31st, 2008 at 11:00 am

my dad is 90 years ole and continues to holler ” Iwant to go home” He does cry a lot but all these tears are not from depression. he is very religious and cries when he is praying…the doctors and nurses deem him depressed……….my mom died in 1993 and two years ago he had to be put in a nursing home………..he had fallen at home and underwent neuro surgery for bilateral hematomas of the brain………………….can you believe his psychiatrist now wants to induce a seizure to control his behavior…………… i am one of 7 living children left on this earth to see that he is given the care he needs and protect his safety…..three of these children voted yes but four of us said “no” He is a DNR and does not want his heart shocked………why in the world would they think he would want his brain shocked…………please pray that we can continue to see this not done to our dad for his remaining years, month, weeks, days?????

AJJuly 22nd, 2008 at 11:17 am

My mother has suffered from depression for as long as I have known her (I am 48). She has had three major depressive episodes, with psychosis and severe anxiety. The first episode she tried medication for two years, only to end up setting our home on fire in an attempt to commit suicide and she killed our beloved dog. She also nearly killed herself. She was admitted to a psychiatric hospital and received ECT. The woman that came out of that hospital is someone I never knew. She was happy, light, carefree, and smiling. There were no problems with memory loss or forgetfulness. Six years later, we went through the same thing – two years of meds and they don’t work, only to end up back in a psych hospital and ect again. Same great response for her. Now she is battling her third episode and again we have tried meds for almost two years and she is getting worse again. She has been approved for ECT after meeting with two psychiatrists and will be admitted to a medical hospital rather than a psych hospital because of her age (she is 84) and medical needs. I have no reason to expect anything but good results again for her. Educate yourselves and you will see that the benefits of ECT far outweigh the risks. My Mom is living proof.

Nancy BaumgartnerJuly 24th, 2008 at 11:50 am

Those struggling with intractable depression, bi-polar, panic/anxiety, OCD, and other psychiatric issues that meds and therapy can’t address should read up on Lyme disease and its coinfections. At this time the vast majority of the medical field is woefully ignorant around the scope and severity of chronic Lyme neuroborreliosis, even the so-called “experts” at extremely distinguished medical facilities. Most people, including many physicians, don’t realize that there is no reliable Lyme test at this time- its a clinical diagnosis. As a result, the borrelia spirochete, which is a cousin to syphilis, is happily wreaking havoc in the central nervous systems and psyches of thousands of people, including me a couple of years ago.

Please read the work of Dr.Joseph Burrascano, Dr.Richard Bransfield, Dr.Virginia Sherr, and review the diagnostic criteria and guidelines published by ILADS (International Lyme and Associated Diseases).

Thanks for reading all this!

JosephNovember 17th, 2008 at 2:36 am

Hi,

I had ECT for 12 times. It worked, but only for a short time. I lost all of my memory. Everything. But here’s what happened-gradually, I gained a lot of it back, by really pushing myself to remember. It is my belief that ECT doesn’t destroy memory, so much as push it to the top shelf. If you have another person around you, have them take notes about your life, conversations, photos of people, things like that. Once people told me about things, I could remember stuff. In this way, I think it is possible to restore all but a few months of memory immediately around ECT. Just keep working at it. Also, just saying all ECT is bad or causes memory loss is too simple. The skill of the doctor really makes a difference, where they put the electrodes, and your condition beforehand makes a big difference. If you have other nervous system problems, look into those first. I just had Deep Brain Stimulation for depression-it’s brain surgery. There’s only about 20 people who’ve done this-6 in Canada and the rest in the US. It was much harder than ECT and more risky. It’s major major surgery. My views are, I don’t care if any of these treatments cause damage, or memory loss as I have nothing worthwhile to remember, and being depressed is worse than brain damage. Being depressed for me is not getting out of bed or being able to even eat food-then starvation begins and I get so weak I can’t walk. I have a friend who lost half her brain-she really is brain damaged. ECT is like scattering all the office papers around. Brain damage is like burning all of them. In a way, ECT helped me to forget all of those bad depressed memories, and focus on what is ahead. Relearning everything was also strange, terrifying, yet wonderful as well.

Melissa SmithJanuary 26th, 2009 at 5:59 pm

I have been hospitalized 5-7 times over the past year and a half, i think. I also know I have had at least 12 treatments, possibly 15, some in patient and some weekly as an out patient in out patient surgery. I have had the same Dr when I was in patient and out and who gives me the treatments.

I have had to call my mother and or husband while driving, to find out where my bank was and or how to get to it. When I meet people I have to instantly make a disclaimer that I might not remember their name, or our conversations. I don’t remember movies that I have seen prior to ECT or after. I don’t remember my hospital stays, why I went in or when I came out, prior to ect or after. I will not remember conversations from day to day, after a week or so. I can not think of what appropriate or what word would naturally be next in a sentance, like; “where is the uh uh uh uh, thing you use to put trash in? Answer: trash can. So my Dr got 8 more treatments for me and I have put them on hold due to memory loss and am scared it will not return, example, like my Doc’s phone calls since I have cancelled my treatments. I was the hardest stick the nurses would say in surg prep, sometimes I would get 3-4 sticks before the manager, head nurse would come in. I have some veins that are perm. damaged. I also had an Intern anestheologist (sp) give me the wrong med to put me under, it was a blood pressure med used to lower the pressure in preg women, levatathol (sp)and was kept all day with blood pressure taken every 5 minutes etc……Any way coments etc. please…………..get back to me. Thanks in return.

Melissa in Okc

PatsyJanuary 26th, 2009 at 8:53 pm

To Melissa:

It’s normal to lose your mental map due to ECT, so I’m not surprised that you would need to ask how to get to the bank. But if you don’t remember where the bank is, then maybe you shouldn’t be driving yet.

I’m so sorry you are having such a tough time. It sounds like a good idea to take a break from treatments. It’s tough sometimes to decide when end a series of treatments. But it’s important. And unfortunately, this important decision comes at a time when we are not thinking clearly. It would be good if you could rely on someone close to you to monitor how confused you are, and then they could recommend to you when it’s time to end the series.

DeniseFebruary 10th, 2009 at 9:40 am

Joseph,

I’ve just been browsing this board and came across your message stating that you’ve had Deep Brain Stimulation.

I’m really interested to know about this treatment as I’ve been following it for a long time. I don’t need it at this point in time because I do have medication that help me, not as much as they used to but they do help me. It’s nice to know that Deep Brain Stimulation has helped some people with their depression and it gives one hope to know that they are still working on new treatments and not just churning out the same me too type of treatments.

My depression is more agitated, suicidal thougts kind. So I am still able to function but just have this chronic excruciating anxiety (when I’m very bad). However, Zyprexa has always been a God Send for those times.

Anyway, I’m really interested to know about the Deep Brain Stimulation procedure and whether you have found it to be helpful. I really hope so as it sounds like you’ve been through hell and back.

Denise

CharmFebruary 24th, 2009 at 3:22 am

I find it really helpful to hear other peoples stories about their ECT. I have suffered Depression, Post Natal Depression, Post Natal Psychosis and again intense, paralysing, physical and mental pain from Depression for over 18yrs now. Depression is not something you can explain to someone who is “normal”. Medications have helped over the years, currently I’m on Nortriptyline & Seroquel, (soon to add Lithium) but their effects seem to be becoming less and less with each year. So I was given the option of ECT. Obviously this idea scared the absolute life out of me, but life was very quickly becoming too difficult for me to cope with and as I have two small children caring for them properly had become very hard. The thought that I may loose my children and be unable to care for them was definately the catalyst for me to go ahead with the ECT. So far I have had 8 sessions and my 9th being tomorrow morning. On the negative side of ECT is definately short term memory loss, which I am finding difficult to cope with, even some day to day self cares can be difficult to remember, I have found that I need to be told instructions repeatedly now or have them written down or there is no way I will remember them, I am also one of those patients who gets migraines at the end of the treatment and have found myself waking up from the anaesthetic screaming in pain only to be re-anaesthetized again and given pain relief before being re-awakened again. Now you would think with all of these side effects I would give up ECT as a bad joke BUT I have had the most amazing positive response from this treatment, I smile, I laugh, I can cope with what life can throw at me, I will be able to return to work (which I love as I am a Registered Nurse), I can interact with people in a positive, happy manner and mean it. I feel Joy, which I haven’t felt in years. Even all of my family are making comments that I look and sound happy, yes happy, something that I so infrequently have felt over the years. I have been having Unilateral ECT & along with me there are currently two elderly patients having the same. They have reported that they feel it is working for them also. Obviously ECT isn’t for everyone but I have found it to have the most remarkable positive effect on my affect, I don’t know whether I would go through another round again in the near future as the memory loss does upset me, but really this treatment has definately improved my outlook on life and has really given me a positive bounce in my step.

Catherine HerrmanApril 27th, 2009 at 3:30 pm

I am doing a dissertation on the need for cognitive rehabilitaion following ECT, even with elderly patients. If anyone would like to contact me in regard to this, please email: acherrman@gmail.com

megsJuly 8th, 2009 at 6:43 am

I had 15 ECT treatments last year in Dunedin (NZ) split into two lots, I consented to it and like the woman from christchurch I was not informed of long-term damage, I was told the memory loss would only last for a few weeks after the treatments stopped. It’s been 8 months since my last treatment and short term memory (especially non-verbal i.e. faces) has only got worse.

ManolaJuly 8th, 2009 at 8:47 pm

I am so scared to go for the treatment, but I have been on so many medications (probably tried all medication known to treat bipolar and manic depression. I felt some hope exploring the possibilty of ect. To think of going back to how I felt before I was diagnosed 8 years ago is so tempting. Can I get examples of what things you forget or what is recent memory.

MegsJuly 9th, 2009 at 5:07 am

I know it’s a very tempting thought when you’re unwell. I think what you have to do is weigh up things like how debilitating your illness is, your safety, other options against the potential side effects (and how long they last). I don’t know if I agree with it being banned, I think I would have killed myself had I not had the first lot of ECT but I do not believe the second lot was as necessary.
The main things I forget are non-verbal things like faces: I can remember names but not faces, I can remember for example that sarah has glasses but if I meet her with a few other people wearing glasses I can’t work out which one is Sarah, it is very embarrassing. Also when I’m looking for a shop I have been to once or twice before in the past few weeks I sometimes can’t find it, I can find it if I tell myself “it’s next to….” or if I have the address. I also have trouble with the order of things, my memory doesn’t seem linear, there are lots of memories but I can’t put a lot of recent ones in order. I also sometimes forget what I’m saying in the middle of a sentence a lot more than I used to.
I think ECT should be the very last resort.

KateJuly 10th, 2009 at 2:44 pm

Would I recommend ECT? Sure, if what you need is something that will most likely be more of a band-aid to get you through your darkest period to the point that you can begin working on your problems. Of course you need to consider the risks and decide if those risks are worth it to you. My memory is total crap but being alive makes the hardships caused by the memory loss worth it.

But also (and I think this is something doctors need to understand more than their patients) ECT can’t cure or even help with some of the problems we folks who suffer from depression need to work on. ECT will not bring back my beloved friend who died ten years ago. ECT will not bring back a failed relationship that left me untrusting and afraid of intimacy (leaving me eternally single and lonely), and ECT will not repair the difficult relationship I have with my mother. However, ECT kept me alive long enough for me to acknowledge those problems and begin working on them myself.

We all have depression for different reasons and I’m only reporting on my own experience. I just hope that if you are considering ECT you have done lots of research before you decide. I also hope that whatever treatment you decide on helps you get through such an ugly time.

ManolaJuly 10th, 2009 at 8:14 pm

Thanks Megs and Kate. You have certainly helped me understand. I think I will give medication another chance.

MLSJuly 27th, 2009 at 2:36 pm

I suffer from Bi Polar depression. It was first thought to be depression, then after my children severe postnatal depression and then finally after a suicide attempt I was diagnosed Bi Polar and a course of ECT was recommended as my meds were not working. I completely lost my short term memory. It did initially help the depression but it eventually came back worse than before. It is two years later and I am wondering if I am losing my mind as I still have extreme difficulty with short term memory loss. I am a teacher and I have to keep re learning my lessons, I can’t remember anything I’ve written and it is extremely distressing. Am I losing my mind completely or could it still be effects of the shock therapy. Please if anyone has an answer for me I am terrified I will never get better.

JSAugust 1st, 2009 at 9:05 pm

My depression began with the birth of my first child and got worse each time another child was born. I went through every drug my doctor could think of in the past 25 years. After being hospitalized several years ago, I finally consented to ECT. And it was given to me upon three more hospitalizations. It saved my life though it does cause memory loss. For the last two years, I have been on maintenance ECT treatments every other week. You can say something to me and three minutes later I won’t remember what you said. I was on my way to see my parents, and couldn’t remember which roads to take! But, I’m not seriously depressed. I just lost my husband of 32 years, so if the treatments weren’t working, it would certainly show up at this time…

catherine freemanFebruary 23rd, 2010 at 2:09 pm

I tried 7 ultra brief unilateral with no success. So we have switched to bilateral. We have had 7 treatments of bilateral so far with little improvement of the depression, yet elimination of racing thoughts and disorganization. The only draw back is the benefits are beginning to abate after only 4 days. I am contemplating quitting. I have suffered from major depression just about my whole life. I am currently 39 years old diagnosed with moderate bipolar. I want to get better to such a degree that I am willing to take educated risks. I have been told not to worry that my memory will come back. I wonder if anyone has statistics of the amount of people with permanent damage and\or success rate of treatment. Sincerely,
Catherine

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