BBC News
20 September, 2001

Measuring the levels of a hormone could help doctors decide whether it is safe to give a patient electro-convulsive therapy (ECT).

ECT is a controversial treatment used to relieve the symptoms of severe depression.

There is evidence that it is effective at relieving these symptoms in many cases.

But some of those who have undergone the treatment claim they have suffered long-lasting cognitive side effects including memory loss, mood swings and recurrent head-aches.

Now, a team of scientists, led by Thomas Neylan, from the University of California in San Francisco, has found that levels of the stress hormone cortisol might indicate which patients will suffer most from these side-effects.

Serious consequences

ECT is carried out under anaesthetic and a muscle relaxant is administered to patients to prevent the muscle spasms that the treatment would otherwise cause.

If susceptibility to these side effects can be predicted it is important to know

Alison Cobb, Mind
Dr Neylan said: “Most people, if not all, will have short-term cognitive side effects following ECT, but in some people these effects can last much longer with serious consequences.”

In his study, Dr Neylan took saliva samples from 16 patients, all of whom had consented to ECT, before treatment to test levels of the hormone cortisol.

The patients also underwent tests to assess their mood, cognitive functioning and memory before and after the treatment.

The results found that the higher the base level of cortisol in each patient, the higher the cognitive impairment after ECT.

These preliminary results, although only based on a small study, could provide doctors with valuable information when deciding whether or not a patient suffering from severe depression should undergo electro-convulsive therapy.

Alison Cobb, from Mind, told BBC News Online: “Memory loss is one of the main side effects that people can have from ECT and it can be permanent.

“In a recent survey carried out by Mind, 42% of respondents reported loss of past memories as a permanent side effect, 36 per cent difficulty in concentrating and 27 per cent inability to remember new information.

“If susceptibility to these side effects can be predicted it is important to know.”

She added that the patient’s own opinion should be one of the most important issues when decisions about ECT are made.

No-one, she said, should be forced to undergo ECT against their will.

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