Electroshock comeback raises tough questions

by Helen Fallding

Today's Seniors, London Edition, March 1997

Mary lives in a London nursing homes. She sits in the lounge,rocking gently and looking into space as she talks. Diagnosed with depression, Mary goes to London Psychiatric Hospital(LPH) once a month for electroconvulsive therapy(ECT). Popularly known as electroshock,the treatment involves attaching electrodes to the patient's scalp and delivering enough electrical current to induce a seizure. Most people feel better after half a dozen treatments, but the effects wear off after about a month.

ECT is making a quiet comback as psychiatrists realize antidepressant drugs don't work for everyone. The typical electroshock patient is an elderly woman living in an institution. Doctors usually prescribe medication for depression, but aging brains don't respond well, says Dr. Kiran Rabheru,head of geriatrics at LPH.

The hospital is the largest treatment centre in southwestern Ontario. It delivered 562 treatments to 66 patients last year, up from 304 treatments five years ago. Patients typically receive three treatments a week for as few weeks, then go on antidepressant medication or maintenance ECT to prevent a relapse. ECT is generally seen as a last resort, but Rabheru thinks it should be offered earlier. "If I had a serious depression, thast's what I would want for myself."

Mary,now 68,was in bad shape before she started getting ECT. She couldn't sleep at night and she tried killing herself with an overdose of aspirin. Though she's been feeling better before for a while now, she still goes in for her monthly treatment.

The Ontario ECT consent form states that "temporary impairment of memory may occur," and, according to psychiatrists, memories return in about six months in almost all cases.

But some patients tell a different story..Jane, who fell into a depression after her husband died, has paid a high price for feeling like herself again. After about 18 treatments, she no longer knows her way around London. Jane wants to pass her history on to her grandchildren, but she doesn't remember it.

Opponents of electroshock claim ECT causes brain damage. Most of the big names in ECT research say there's no evidence of brain damage but opponents insist their work is suspect. The report of the American Psychiatric Association's 1990 task force on ECT is peppered with references to Dr.Richard Abrams, who, according to The Washington Post, co-owns one of the world's largest ECT machine companies.

Wendy Funk-Robitaille used to be a social worker; now she says she can't even get a job in a corner store because she can't do arithmetic. "I don't remembrer being a kid. I don't remember having my kids. All of that is gone."

Funk-Robitaille is suing her doctor, her psychiatrist and an Alberta hospital, in what she has been told is in the first case of its kind in Canada. She's worried about the older women who are prescribed ECT more and more often these days. "They don't have anyone to stand up for them."