“Substantial” Relapse After ECT,
With or Without Medication


The Journal of ECT, looking at the question of whether antidepressant medications at the start of ECT reduced post-ECT relapse in a sample of 319 patients, notes that 50% of the patients relapsed and 16.4% dropped out; leaving 33.6% in remission after 6 months.  “Relapse rates after ECT are substantial despite intensive pharmacology,” the authors note. Abstract → Prudic, J., Haskett, R., McCall, W., Pharmacological Strategies in the Prevention of Relapse After Electroconvulsive Therapy.  Journal of ECT. Online January 8, 2013

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. If people were given full disclosure about the medications and the procedures, most would never agree to them. Isn’t the point of an antidepressant to no longer feel depressed? Isn’t the point of an antipsychotic to no longer experience the kind of symptoms that got you a label in the first place? Call me naive, but I kind of expected when my son was placed on medication that he would become well again, able to resume his studies, hold down a job, etc. The fact that neither happened within a reasonable time period of being on medications, made me seriouly question what they were supposed to accomplish.

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  2. I have read in the literature that ECT may induce delirium which is dangerous and an ominous portent of Neuroleptic Malignant Syndrome, yet ECT is foisted on patients for treatment-resistant mania which may in fact actually be delirium and iatrogenic. My understanding is that once a person has had delirium or NMS they are presumed to be at higher risk for it in the future; my point being that ECT and the anti-psychotics are a risky game of roulette and medical staff have nothing to lose, yet the patients are expendable.

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