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: Feb 7, 2007 11:10 am | Trackback URI |  Email This Post  | Print