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.