The Director of Mental Health at the World Health Organisation, Dr Benedetto Saraceno, has said on the public record that ECT without consent should be prohibited. In terms of human rights, he compares involuntary ECT to the practice of "direct" ECT, which is ECT without any anaesthesia, a truly barbaric practice that occurs in many countries but is not permitted in Australia. Invountary ECT, however, is routinely carried out throughout Australia and, as Sam Westgarth's article shows, is increasing at an alarming rate.

Thanks for breaking the silence on this, Sam.

ECT works.

It has side effects. None of this is particualrly revelatory

It looks pretty weird - in a past life I was involved in its adminstration.

It is safe as any other procedure undertaken after a person is rendered unconscious - that is, there are always risks of anaesthetic death -

My mother has had ECT. I felt it a better option than having dead mother at the time.

The author writes as though all the side effects are visited upon all the subjects all of the time. Nothing could be further from the truth.

ECT can be administered irresponsibly - the problem does not lie with the form of treatment itself but with a health system that will allow for the indiscriminate adminstration of any number of treatments, and ECT is only one of them, in a poorly scrutinised system.

I am with Sneekeepete.
It works.
A friend of mine suffers from schizophrenia and was institutionalised as a result of her failing to take her medication. Many different treatments failed to produce any improvement to her mental condition.
Thanks to ECT, administered under anaesthetic, which was tried as a last resort, we now have her back again, functioning normally, although still receiving fortnightly injections from the district nurse.

David

With respect, this article is an outstanding example of the “sheep” (and somewhat alarmist) approach to a very serious health issue. I make the following observations:

1. “One in four Australians suffer from some kind of depression….the Australian public has cause for concern.”

The correct figure is 1 in 5, which is across a lifetime, not at a given point in time (as this seems to infer). “Some kind of depression” covers a wide range of situations and diagnoses, only a very small proportion of which would be potential candidates for ECT treatment.

2. It is debatable whether a person with serious (or even moderate) depression has the ability to give “informed consent”. It is not a simple case of saying “yes” or “no”. Mental capacity in most cases will be significantly diminished by the effects of depression, including confusion, memory loss etc.

3. A medical specialist is under no obligation to explain his or her treatment recommendations to a semi-informed journalist.

ECT is a last-resort form of treatment that isn’t well understood, granted. However, the point that has been completely missed here is that the forms of depression that make people a candidate for ECT is also “barbaric”. It is vastly worse than one would imagine. My experience resulted in a shift from an IQ of around 135-140 to an IQ of perhaps 85-90. Some days I struggled to tie my shoes.

Where severe symptoms persist and have not responded to other forms of treatment, it is not even remotely humane to leave patients in a state of intense pain when successful (if imperfect) treatment is available.

As an undergraduate, a psychology professor noted that signing one’s informed consent for ECT while in a “healthy” frame of mind is likely to be an valuable protective strategy for anyone sliding into “the abyss”, should the question arise at a later point in time. Having suffered reasonably serious depression, I’d prefer skin burns and memory loss to that frame of mind every day of the week and twice on Sundays

The attempt to link modern ECT to the horrific scene from One Flew Over the Cuckoo's Nest is risible. It's like comparing modern surgery to a back-alley amputation by a 19th century barber.

I suggest that Edward, an inpatient at a psychiatric ward, perhaps isn't the most reliable source of an informed, balanced opinion on ECT. He probably also thinks Satan is communicating with him through the pages of the Financial Review.

And just quickly, Eljay, you mean "implied", not "inferred".

Sancho said: "And just quickly, Eljay, you mean "implied", not "inferred"."

Picky, picky! I was about to fire off a similar note about the use of imply/infer, recently. Yes, in its original usage, one implies something with one's words and another draws an inference from them, but the dictionaries I consulted seemed of the view that the weight of common usage rendered either acceptable. Anyway, that is far from the worst linguistic crime I have seem committed on this forum.

Anyway, to the point. This article is some of the worst drivel I have seen served up on OLO. I am no expert on ECT but the standard of writing/research/"journalism" is apalling. To wit:

"As reported with the use of the contestable “Tazor”"

Did you mean "Taser?" Did you mean detestable?

"I decided to help her seek some sort of third party."

Third party what?

"If the current were not limited to the head and were not in such short spells, it would kill you instantly."

Yeah - but it IS limited to the head and it IS in short spells. So what is the point? That is like saying that if you tried to defibrillate someone's heart by hooking them up to the mains instead of using an AED, it might kill them. Yes, it might well! So what!

"It is well known that the practice causes the destruction of memory synapses in the brain resulting in amnesia."

So what is a memory synapse, Sam? Is it different to any other synapse in the brain? Do you even know what a synapse is?

As for referencing Wikipedia in an article about something scientific - just ludicrous. And while we are at it, the fact that one guy committed suicide after ECT, proves neither causation nor generalisability. So why mention it?

And all of the above in addition to what other have already pointed out.

Sam if you want to be taken seriously as a "freelance journalist" you better pick up your game a bit. This is pseudo-scientific babble.

Good grief...I missed the Wikipedia reference!! Wikipedia has about as much academic credibility as my cat...and yes, I know about the Britannia comparison study.

“Invountary ECT, however, is routinely carried out throughout Australia and, as Sam Westgarth's article shows, is increasing at an alarming rate.”

Sam’s article doesn’t show anything of the sort: it’s an opinion piece that has largely been “researched” through the least reliable parts of the Net, the Daily Telegraph, a couple of vested interest groups, a blogger and a couple of patients.

“ECT can be administered irresponsibly.." etc etc.

I spent three years working as a medical researcher in Sydney. Hospital ethics committees are incredibly scrupulous, there is oversight from NH&MRC, and they rely on a battery of checks and balances. They would be exceedingly hard to circumvent without collaboration from a group of health professionals trying to jeopardise patient health for no apparent reason.

Sam’s remarks about “what causes depression”, what “most psychiatrists” believe and suicides following ECT treatment are motherhood statements that are largely drivel.

I suppose the most distressing aspect of this publication is that is may increase the numbers of well-intentioned but ill-informed individuals getting involved in issues they know nothing about.

The real implication of that is that people who *could* benefit from this treatment – and most patients do, despite its faults and problems and questions – may be denied it.

On the upside, and in light of my own history, this has reminded me to advise a couple of close doctor friends that in the event of the question being asked, I would want to want to run the risk of ECT if the only other option was serious and unremitting depression. (Lest my health care ever get into the hands of anyone like Sam...)

(My Oxford dictionary suggests that Sancho’s point is correct...albeit a fine and debatable line...!)

Eljay's comments about my article are an example of the 'wolve' mentality- which seek to discredit whole schools of thought.
1. There are various stats about the number of people who will experience depression 'in a lifetime'- 1 in 4 was the highest estimate- and while this does not mean that 1 in 4 will receive ECT it does mean that there are an ever increasing number of people who could be 'candidates' for ECT.
2. ECT.org believes all medications or treatments should be voluntary. (Doctors for eg, like to compare mental health issues to physiological conditions- if someone had a heart problem for instance, no one can force them to have an operation, but through informed consent you may be able to persuade them that it is in their interests.) And...If one is 'confused' and forgetful before ECT surely they should not be after the procedure...

EL jay cont....3. It is irrelevant that you think I am semi-informed... And just say I was, it would have been no help trying to contact an expert or practitioner of ECT- would it?
Besides- A doctor working in the public service has a duty to inform and liase with the general public!
- i) also you admit yourself that ect reduces IQ- if one has to be dumb to be happy- then what a sad world we live in.
ii)sure it is wrong to leave people suffering- but when some people have bad experiences and continued pain after ECT it becomes self defeating, and more than not other methods like counselling have not been applied....--While the article had a negative bent this was not due to any semi-information but because of new information about ect.

I think the use of ECT is a deplorable practice. Common sense would tell you that putting that much electricity through a person's brain is not a good idea. Without any understanding of the mechanism by which this treatment is supposed to help people, psychiatrists are nothing better than the snake oil salesmen of the 19th century.

It is deeply disturbing to me that psychiatrists appear to want to play god and seem to have less concern for their patients than for their own career and legacy. We are only now discovering that SSRI's can have incredibly serious side effects sometimes worse than the original illness, but psychiatrists are always looking for that silver bullet which will fix everything.

Obviously depression could be easily treated with the use of opiates if we really wanted, except that it would cause dependence; drug dependence is of course acceptable when it is to psychiatric drugs like SSRI's or lithium or thorazine or some such thing.

Sure ECT might make patients less depressed, but I'm sure a lobotomy would as well.

sam_swestgarth said "- i) also you admit yourself that ect reduces IQ- if one has to be dumb to be happy- then what a sad world we live in."

Sam - he quite clearly said nothing of the sort.

This is Eljay's quote:

"ECT is a last-resort form of treatment that isn’t well understood, granted. However, the point that has been completely missed here is that the forms of depression that make people a candidate for ECT is also “barbaric”. It is vastly worse than one would imagine. My experience resulted in a shift from an IQ of around 135-140 to an IQ of perhaps 85-90. Some days I struggled to tie my shoes."

Since you're having trouble interpreting that, let me do it for you. What he is saying is that his DEPRESSION was so debilitating that it reduced his IQ to that level, not the ECT!

Yes Tom Paine, it is deplorable- shooting an electric current thru the barely understood brain is no more advanced than the Mayan practise of cutting a hole in the skull to let out evil spirits. I've meet a few 'droids over the years, allegedly cured of their afflictions- give us a break!

Since first reading about Harry Bailey Ive kept a weather open for stories in this area and have concluded that 1. there is no real science to back up this mis-treatment and 2. proponents are always at best shrill and at worst loopy and 3.it is hard to imagine anything that robs a person of their dignity more than this treatment.

Over 20-odd years I watched my mother with depression receive regular ECT, which did nothing for her. It certainly affected her memory long before she succumbed to dementia. I have a brother who was suicidal or play-acting as such. He received "more sophisticated" treatment and that left him more cretinous than I would have thought possible.

In it's own way ECT is as barbaric as was frontal lobotomy.

Drug treatment and therapy surely must be the first line of attack on depression, not late medieval brain "fritzing."

I don’t really know enough to comment either way on this ECT treatment though I'm inclined to agree with Tom's comments.

It might offer hope as a useful last resort for treating very severe depression and I can certainly understand how someone in this situation might think the associated risks are worth taking. I can’t add much on this but I can offer information that may be of use to people suffering the less severe though no less debilitating cyclic and endogenous depression. This type of depression is commonly a result of underlying hypoglycaemic disease, which isn't usually diagnosed as it's not a condition well understood by most conventional medical practitioners.

When hypoglycaemic disease is present, as with diabetes, the pancreas doesn't handle sugar properly. Instead of producing no insulin as in diabetes, it produces too much. When sugar is ingested, there’s an initial spike in blood sugar levels followed by a drop to very low levels. This low level of glucose in the blood means that the brain becomes starved of glucose, which in turn leads to depression and as well memory impairment, poor concentration and lethargy.

This is one of the reasons why the incidence of depression is becoming ever more prevalent. There is just so much sugar in the modern western diet and those who have this inherent susceptibility will be affected by it. An estimated 60-70% of people suffering from depression have underlying hypoglycaemic disease so it might be worth looking into if you're a depression sufferer.

It’s a lifetime condition but it can be managed very successfully and very naturally through the adoption of simple dietary and nutritional measures. I had lived with depression all my life until I learnt of this and made these changes and would certainly recommend it to anyone else in this situation.

ECT what no one is talking about

My first wife had ECT in UK, before I met her, for depression following the unraveling of her first marriage and death of her father. I cannot really say what effect it had on her, not knowing her before, although after she was still “prone” to depressive states, particularly post childbirth. If I recall correctly, it was inflicted upon her involuntarily and considered a suitable remedy at the time. She was committed by her first husband and got released when her mother went and kicked up hell and demanded her daughters release.

Now the view of the experts is changing.

“Chelmsford deep sleep therapy” was another “procedure” which was found to be less-than-beneficial to patients, although some “scientific” research must have been undertaken before hand to justify it.

http://www.cpa.org.au/garchve2/992chel.html refers

Off topic and not to labour the point, I cannot stop wondering, all these “expert” opinions on global warming, will they wax and wane in the years to come too and fall into disrepute?

Strange, I can almost feel it happening.

1. No need to try to discredit sources of information that are not creditable in the first instance. I’m a researcher by profession, I have a Hons degree in psychology, and I’ve read the available literature reasonably widely. (What’s a “wolve”?)

2. Voluntary agreement is the preferred option where that is available, obviously. The point is that many patients needing ECT are not able to give true “informed consent” due to the difficulties of processing complex information when seriously depressed. Similarly, persons under the age of 16, affected by dementia or with an IQ of less than 70 cannot (generally) give informed consent. (This does not preclude their opinions being sought on decisions that affect them, which is generally done).

3. ECT treatment does not involve the instantaneous disappearance of all symptoms at the push of a button. Nor does it does not necessarily follow that a patient “should” have an improved memory immediately (or days) after treatment. Indeed, impaired memory seems to have a valuable function (namely, to forget as much of the depressive / treatment episode as possible). It can’t distinguish between that and remembering a name. ECT treatment also takes about a dozen treatments to generate benefits over the longer term.

4. It’s fine to seek advice from a doctor, but he or she has no obligation to assist you personally. Did it occur that they may have been, I don’t know, treating actual patients? There is plenty of valid, free, research-based information in the public domain – eg. BeyondBlue, the Black Dog Institute – however you’ve frequently relied on sources that are unreliable or invalid

5. I didn’t say that ECT reduces IQ or anything like it. What I said was that serious depression reduced my IQ at one stage. That was a short-hand way of saying that the disorder impaired my ability to process information, or "cognitive ability”. Poor concentration, for example, is often used as an indicator of clinical depression. (Thanks for the support Stickman!) (I'm a "she" BTW!)

6. Experts commenting on issues like "global warming" is a completely different ballgame. Many would argue that making predictions is not research, even though the redictions may be research-based. No research method or field is infallible, but at least the main methodology in medicine is empirical experimentation with error margins that are quantifiable.

Not all "scientists" work in the same way and the reliability of "expert comment" can vary markedly between fields.

7. Counselling – shown to be quite effective in many contexts – often does not work with ECT candidates due to the cognitive impairment. A seriously depressed person can have a limited ability to absorb and process information or discuss an issue.

Sorry Sam, but please, if you aren’t prepared to take the time to understand the issues properly, please report on things where you'll at least do less damage.

Unfortunately, you are confused / misinformed / unclear on a range of aspects of this issue in your article, including the concept of "informed consent". The crux of this isn't about "pursuading" anyone to do anything. It's about placing patients (who do have the capability) in a position of informed knowledge about the advantages and disadvantages of various treatment options, so that they are in a position to decide what they wish to do.

"I reckon" and "some bloke I met" are not valid research methodologies and it's completely absurd to reject what is known about ECT and mental health issues in favour of these approaches to evaluating ECT as a treatment option

Both my mother-in-law and father were recipients of ECT treatment for chronic depression and underwent many treatments. After many years, both decided to not continue because of the negative side-effects, and to continue with the depression as the lesser of two evils. Neither of these people knew each other and arrived at their decisions independently. My mother-in-law was suicidal in her depressions and needed constant monitoring. I personally knew of several others, four in fact, who had undergone ECT and eventually chose not to continue. In my mother-in-law and father's case, both discontinued contact with their psychiatrists. I wonder how this was recorded. As a 'cure'? It most certainly was not. Yet their experience was, to me, most telling. I realise this is not a representative number in scientific terms but 6 people telling me the same, with no person ever telling me anything positive about the benefits of ECT, leaves me with an impression that after 60-70 years of use, and with still little understanding of it, perhaps it is not as good as doctors tell us it is. I, like many of the population, have experienced episodes of extreme depression, only one of which drove me to seek the help of a psychiatrist, but had he mentioned ECT as a potential treatment, I would not have continued seeing him. In any case, I was lucky and the depressions ran their course, eventually lifting. I realise that not everybody is so lucky, as was the case with my mother-in-law, who had the illness from the age of thirty until her death at 76, but still I have extreme reservations in its use and find myself unable to come to terms with it as a useful tool. I believe it only camouflages symptoms.

Eljay said: "(Thanks for the support Stickman!) (I'm a "she" BTW!)"

Oops! Sorry...think I asumed that because I have a male friend called LJ...

arcticdog said: "I realise this is not a representative number in scientific terms but 6 people telling me the same, with no person ever telling me anything positive about the benefits of ECT, leaves me with an impression that after 60-70 years of use, and with still little understanding of it, perhaps it is not as good as doctors tell us it is."

No it isn't a representative sample, nor would it be representative if it was 60 of your friends and relatives. It's called anecdotal evidence and it is not exactly "quality" research, is it? Have you thought about looking up some studies? Your experience is yours and I am not trying to discredit it, but it isn't research. I have looked up some papers, no point posting links here as you need to have login access, but suffice it to say, evidence in strongly in favour of the use of ECT:

"The primary indication for ECT is major unipolar or bipolar depression. Its efficacy is directly proportional to the severity of illness, especially as indicated by changes in psychomotor rate, sleep, appetite, weight, libido and the capacity to experience pleasure. ECT is considered the treatment of choice for depression in the context of many neurologic and medical conditions, including Parkinson's disease, stroke and pregnancy. ECT is also efficacious in the treatment of acute mania and, in some cases, schizophrenia; it is relatively inefficacious, however, in the treatment of depressive episodes in patients with primary personality disorders. It should be the first choice for patients who cannot tolerate pharmacotherapy and for those, such as actively suicidal patients, in whom a rapid response is needed."

(SOURCE: Kraus, R P. Chandarana, P. "Say, are you psychiatrists still using ECT?". CMAJ Canadian Medical Association Journal. 157(10):1375-7, 1997 Nov 15.)

(cont.)

The review article goes on to discuss bi-temporal vs unilateral (non-dominant) therapy, which the author brought up. He (incorrectly) stated that it is do with left or right handedness. About 95% of right handers are left hemisphere dominant vs 50% of left handers. Cerebral dominance is to do with language and mathematical function, not handedness, which is only a guide.

Anyway, it states that unilateral ECT is less effective but also leads to less short term memory loss. So why is this contemptible?

Also - just because the mechanism of action of a therapy is not known, this does not mean it should not be used. There are plenty of therapies where the mechanism is unknown and hypothesised about. If the evidence is that it is safe and effective, then it should be (and is) used.

arcticdog said: "...but had he mentioned ECT as a potential treatment, I would not have continued seeing him."

Huh? Isn't that throwing the baby out with the bathwater? Presumably there was something positive about the therapeutic relationship in the first place? Besides, as your psychiatrist, he MUST present you with all the suitable treatment options.. to do otherwise is poor professional practice

>ECT is considered the treatment of choice for depression in the context of many neurologic and medical conditions, including Parkinson's disease, stroke and pregnancy.< Pregnancy?
Surely you jest! I would have thought time was the correct treatment for pregnancy rather than ECT. Just as time seemed to have been the correct treatment for my depression that was treated by drugs. Fifteen months after seeing the psychiatrist I moved to a country town for work and could no longer access the prescribed drugs from a psychiatrist. However the depression did not come back. Presenting to a psychiatrist for the first time I would have considered it irresponsible had ECT been indicated as a form of treatment. I thought so then and nothing has changed my mind on this. Perhaps if it had been long term and I was desperate, perhaps my view would be different. But little that Stickman says would cause me to change my opinion on this. The research presented is too narrow. I would like to see more, much more. I believe most of this can be countered factually.

Stickman

"Besides, as your psychiatrist, he MUST present you with all the suitable treatment options.. to do otherwise is poor professional practice."

Very few psychiatrists present patients with the full range of treatment options.

Many psychiatric patients could achieve considerable improvement, if not complete control of their symptoms, through adopting specific dietary measures designed to keep their blood sugar levels on an even keel and thus ensure consistent glucose availability to the brain.

All parts of the brain need a constant supply of glucose to ensure proper mental and emotional functioning. The brain uses close to 50% of all available glucose and unlike the heart cannot use other fuel sources such as triglycerides, cholesterol and free fatty acids. The brains of people with a disordered pancreatic and insulin response are regularly starved of glucose and this results in an array of symptoms associated with mental and emotional dysfunction.

In the words of a specialist doctor in this field, “In psychotic depression as well as in schizophrenia there has been found to be 50 – 60% incidence of concurrent Hypoglycaemic Disease. If the Hypoglycaemic Disease is treated, symptoms of schizophrenia and of psychotic depression tend to be far better controlled and in some cases disappear completely.”

I doubt if many patients presenting to a psychiatrist would come away with this sort of advice. The majority would I'm sure come out with a prescription for anti-depressants or some other pharmaceutical, the vast majority of which will only ever mask the symptoms and even then usually only for a certain amount of time before their efficacy is diminished. They will never correct the underlying metabolic disorder, which is what, in not all but in a considerable percentage of cases, is responsible for the symptoms in the first place.

http://www.hypoglycemia.asn.au/articles/hypo_cure-all.html

would appear to support your case Bronwyn. Not to be dismissed lightly

Also
http://qjmed.oxfordjournals.org/cgi/reprint/91/7/505.pdf

David

Bronwyn

I think you have made very valid points.

I gave up on seeing psychiatrists, after you have analysed yourself, what is left?

For me there is cognitive behaviour modification, which is learning new ways to deal with recurring situations - of course this type of treatment doesn't receive the same level of subsidy as does psychiatry, so it has been an intermittent treatment. I am also careful with my diet - natural, organic unprocessed food as often as I can afford. I never eat fast food now. I also have Myalgic Encephalomyelitis - developed as a result of illness and just trying to keep going. So I am very aware of the importance of diet - however, at no stage in my years of treatment did a psych discuss diet.

As for ECT - it was presented to me more as a threat than a treatment, many years ago when I was complaining that my medication left me feeling like a zombie and I was unable to complete my projects at Uni. Maybe it does work for extreme cases - I don't know but it should be considered a last resort.

With proper support, diet and if necessary medication (I am still on meds) mental illness can be managed. I manage much better now, but it is something I live with all the time, just as people with diabetes live with their condition all their lives.

Despite the publicity there is still a stigma attached to mental illness. People who have never experienced it often feel somehow superior. To them I say, "it can happen to you - all it takes is the 'right' set of circumstances to bring you down."

Fractelle

There’s a couple of posts of mine at the end of RObert’s article discussion on “Men – Keeping it inside or spilling our guts” that you might be interested in. The second one contains a website that I have found extremely useful.

I see you contributed to that thread earlier on but you may not have stayed with it to the end. I tried to add the links here for you but I got stumped at the clipboard stage! My computer skills (or lack of them) let me down at times!

Thank you Bronwyn

I have book-marked the site.

Now to everyone, please watch Andrew Denton 'Enough Rope' tonight or record for later viewing.

For a review please see below:

http://littlurl.com/fybh8

What a surprise! Just came upon this article. There is so little public discussion in Australia about the use of ECT, and we need that discussion. This article serves a valuable role just in raising awareness of the practice. Thanks to the author, and to admin for re-opening the thread. Unfortunately, it's not easy for brain-injured folk to assemble their thoughts on a complex topic, but I'll try.

Can it really be "distressing" that ECT should be discussed in public by those who have not necessarily been trained in medical science or an ancillary profession? From this standpoint, it has been seen as a "damaging" act to even raise the topic. "Ask no questions, just pop up here and leave it to doctor."

There are many valid perspectives on this issue, not just the same old one pushed by the medical establishment. Surely different points of view can be presented and tolerated here without those from the medical establishment feeling threatened by such contributions. There have been very few studies of the long-term effects of ECT, but this does not invalidate the experiences of those who have first-hand experience of those effects.

As for the contributor who claims support for the practice of ECT from papers so restricted they can't even be cited in the usual way - there are still libraries for those of us not privileged with "login access" - well, what can I say? Might you just as well have saved your breath? - even Wikipedia often cites references. And the abstract of out-dated clinical notes that someone posted as support for the practice of ECT – I suspect that, given time, even I with my burnt-out brain and scrambled cognitive capacity might be able to come up with something a little more recent and informative – and available to all. If I find it, I'll be back.

Richenda

Hi, is anyone interested in links to recent ECT papers?

After a bit of a googling I have come up with a few recent ECT results, a couple published in the last year or so. If anyone's really enthusiastic, there are also the references given in these publications to follow up, and so on.

http://apt.rcpsych.org/cgi/reprint/12/3/228.pdf?ck=nck

http://ajp.psychiatryonline.org/cgi/reprint/158/2/305.pdf

http://www.nature.com/npp/journal/v32/n1/full/1301180a.html

http://apt.rcpsych.org/cgi/reprint/13/2/90.pdf

http://bjp.rcpsych.org/cgi/content/full/186/5/410?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=186&firstpage=410&resourcetype=HWCIT

http://psychservices.psychiatryonline.org/cgi/content/full/53/8/1040-a

http://www.rcpsych.ac.uk/files/pdfversion/cr128.pdf (ECT Handbook : 256 pages)

I'd say that the message is that ECT should only be used as a last resort, with due attention to the state of the patient regarding age, state of health, previous mental something (capacity? acuity?), education and other factors. A significant proportion of ECT recipients suffers from short- and/or long-term “non-target” effects on memory and cognitive abilities.

My personal experience is that I emerged from ECT treatment as an impaired individual – even more impaired, that is - with a totally changed future. That's after 12 treatments 5 years ago.

There are many who are thankful for ECT treatments they have received, despite side-effects or even for fortunate individuals, with no subjectively noticeable side effects.

Of course, if there is no neuropsychological assessment of a patient's abilities prior to treatment, there is no baseline against which to compare post-ECT abilites. No-one receiving ECT at the same hospital as me mentioned testing, nor were they gone from the ward long enough to have received the extensive testing that is necessary, before ECT was administered. Concerns about memory deficits that I expressed to the psychiatrist after treatment were waved away. There has been no follow-up by that hospital or anyone else into the long-term outcome of that ECT treatment I received.

Richenda

Thank you Richenda, for your injection of information into this thread.

My scanning of the papers lead me to a similar conclusion to you: ECT is a potentially effective treatment which should be used very carefully, with attention to the circumstances of the patient, as it has the potential to cause profound harm.

Some quotes from your linked sources that caught my eye:
"there has never been a large-scale, prospective study of the cognitive effects of electroconvulsive therapy (ECT)";
"in the ECT group memory recall deficits emerged and memory complaints remained"; and
"possible permanent adverse effects of the treatment,[...] include amnesia, memory disability and cognitive disability".

These quotes from medical researchers steeped in the scientific method really give pause for thought, especially in interpreting the opinions of the ECT supporters here in this forum. As they are advocating the status quo, they need to understand the horrific damage that ECT has caused to numerous patients at one of the most vulnerable times of their lives.

The medical establishment surely has a responsibility to do the least collateral harm possible as it goes about its mission of healing patients. To do this, there needs to be a discussion that openly acknowledges both the benefits and the neurological trauma inflicted by ECT.

Without this discussion, the use of ECT descends from a potentially life saving tool into a process of institutionalised brain electrocution by a group of medical professionals whose confidence in their capabilities has become arrogance; and overtaken their responsibilities to their patients.

I’m not generically criticising these medical professionals, who often do a great job. Rather, I’m saying that one part of not being reckless is making yourself informed of the pros and cons of your decisions. There doesn’t seem to be the public discussion in Australia that shows that this is happening.

If my life ever heads in a direction where brain electrocution may be the best option for me, I want the doctors and psychologists who decide on it to be aware of the risk factors which affect the potential damage that ECT might do to me.