Patient believes electroshock treatment cause of problem

5/19/97
By SHAE DODSON
Globe-News Staff Writer

Jane Betzen, 41, of Amarillo, said she got her first electroconvulsive therapy at the Pavilion in May 1996.

One year later, she describes it as the beginning of a nightmare that led to epileptic seizures and memory loss.

Betzen, who said she was depressed because of a failed marriage, believes she received 17 ECT treatments, also known as electroshock therapy. But she only remembers signing her consent for the first one, and she said the Pavilion will not release her medical records to her.

Betzen also said Pavilion doctors never gave her a medical examination before beginning ECT.

"Who's going to speak out for a mentally ill person?'' said Betzen, who traveled to Austin last month to testify against ECT before the Senate Health and Human Services Committee. "We are in such a state of devastation by the time we get to the point of being in a hospital, who's going to stand up and say we're being mistreated? Who's going to stand up and say that the conditions are inhumane?''

Pavilion Administrator Richard Failla declined to answer questions about Betzen's allegations.

"Legally, I can't do that ... because that would be a violation of (patient) confidentiality rules,'' Failla said.

ECT involves stimulating the brain with a controlled series of electrical pulses to treat certain illnesses, primarily severe clinical depression, according to the American Psychiatric Association. ECT was developed in the 1930s in the absence of medications to treat mental illness.

Failla said ECT is a safe, effective treatment for patients who don't respond to other types of treatment.

"I am not aware of any adverse outcomes from the administration of ECT, and all of the psychiatric literature reflects that as well,'' Failla said.

The Pavilion reported to the Texas Department of Health that it performed 991 ECT treatments last year, more than any other facility in the state. As of May 1, however, the Pavilion has stopped offering ECT as a treatment option, citing growing political pressure and increased scrutiny of its ECT program by the Texas Department of Health.

But some have faith in the safety and effectiveness of ECT.

Michael Sharp of Amarillo, who has suffered from severe depression for the last 20 years, said ECT is the only thing that has conquered it.

Sharp, 40, said he received a series of 12 ECTs during August and September and has been on monthly maintenance ECTs since then. He said he's never suffered confusion or memory loss after ECT and has not become epileptic or suffered seizures resulting from ECT.

"I've taken every antidepressant known to man and did not respond,'' Sharp said. "Finally, it came to the point that ECT was the only thing left. ... I feel better, much better. There is no pain associated with it. ... It's an accepted form of treatment except for uneducated people who only watched `One Flew Over the Cuckoo's Nest.' That's not the way it is.''

Dr. Lynda Parker, regional chair of the department of psychiatry and associate professor of psychiatry with Texas Tech University Health Sciences Center at Amarillo, said ECT is valuable for certain patients when used appropriately. But a patient should meet certain criteria before receiving ECT, she said.

"One clearly is severe depression of a psychotic or delusional nature,'' Parker said. "It (ECT) is also used in schizophrenic situations where you have a catatonic patient who becomes rigid and doesn't move. It's used for acute manic excitement or agitation. It's an excellent treatment during pregnancy when the patient is suicidal and drugs are not appropriate.''

And it's used for people who don't respond to or cannot take antidepressants, which often have serious side effects, she said.

Like any form of treatment, ECT also has side effects, which can include initial confusion, loss of recent memory, headaches and muscle rigidity, she said.

"But that (memory loss) generally clears,'' Parker said. "The memory loss is cumulative and depends on the number of treatments.''

Dr. Peter Guresky, a psychiatrist who previously administered ECT at the Pavilion, said the confusion associated with the procedure varies depending on the patient.

"Sometimes, people can become quite confused, in which case the individual clinician in consultation with the patient has to decide if the benefits of ECT - the treatment of the depression - is being outweighed by the confusion that's occurring,'' Guresky said.

Parker said a physician must allow the depressed patient an adequate trial of more than one medication. Typically the patient should take each drug for at least 10 days to two weeks before trying another, she said.

Parker said ECT is quicker than antidepressant medications and often is more effective. She said she thinks it's unfortunate for patients who really need ECT that the treatment is no longer available locally.

"You don't give an antibiotic to someone who doesn't need it, and you don't give ECT to someone who doesn't need it,'' Parker said. "But when they do need it, it really changes their lives.''

Guresky said ECT is an acceptable treatment for severe depression, but it doesn't work for personality disorders, manic depression or schizophrenia disorders.

He said ECT is effective about 85 percent of the time, and antidepressant medication is effective for about 70 percent of patients.

"It doesn't take long to know if ECT is working,'' he said.

Guresky said the patient is sedated and the amount of electricity delivered to the brain to produce a seizure is highly controlled.

"The amount of electricity that's delivered is just a fraction of the amount of energy you'd experience if you accidentally shocked yourself by sticking your finger in a light socket or something like that,'' Guresky said. "In fact, you can hold your hand on the electrodes when they give it, and it's kind of like a strong battery ... to artificially induce a seizure.''