New Review Highlights Dangers of Electroconvulsive Therapy

Data shows that over a third of users experience permanent memory loss

Peter Simons
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Proponents of electroconvulsive therapy (ECT) claim that it is safe and effective and that the side effects are short-lived. However, a new review, published in the journal Evidence-Based Mental Health, reports on the likelihood of permanent cognitive impairment and permanent memory loss after ECT. The author is Dr. Dusan Kolar, at the Department of Psychiatry, Queen’s University, Kingston, Ontario, Canada.

Dr. Kolar writes that “ECT is one of the most controversial treatments in medicine, particularly because of the still unknown mechanism of action and uncertainty about cognitive side effects.”

“Cognitive side effects of ECT are sometimes underestimated and may last much longer after completed treatment than it is usually expected. These cognitive impairments associated with ECT may cause significant functional difficulties and prevent patients to return to work.”

Photo Credit: Pixabay

Electroconvulsive therapy (ECT) involves the electrical stimulation of the brain with the intent of inducing seizures. It is often prescribed for patients with mood disorders such as depression and bipolar disorder, usually in cases that are severe, with a risk of suicide, or that do not respond to other treatments such as medication or psychotherapy. However, it is controversial due to its uncertain mechanism of action, the risk of severe side effects, and the lack of data about the risks of long-term or maintenance therapy.

Dr. Kolar suggests that the current practice of assessing for cognitive impairment and memory loss is inadequate, and fails to identify dangerous side effects in patients undergoing ECT. Other researchers have noted that the original assessment of side effects from ECT does not identify amnesia. According to the researchers, claims that ECT does not introduce long-term memory loss and cognitive impairment are “based on extremely gross measures of mental function such as the Mini-Mental State Examination (MMSE) and other dementia screening scales” and “very simple, brief measures” that detect only changes to well-established skills, not memory loss.

Researchers, including Dr. Kolar, found that patients routinely receive inadequate informed consent that does not mention the risk of permanent impairment. For instance, the consent forms provided by the licensing body, the American Psychiatric Association (APA), state that “Most patients report that memory is actually improved by ECT.” But researchers say that statement “is contradicted by all service-user research” as well as many findings in the research literature. The researchers identified that over a third of patients experience permanent memory loss. This contradiction may account for why they also found that “Half of people given ECT say they did not receive an adequate explanation of the treatment.”

In recent years, doctors have attempted to mitigate the possibility of memory loss and cognitive impairment by modifying the ECT technique (for instance, stimulating only one side of the brain at a time). However, these findings indicate that the treatment still carries considerable risk. Additionally, these modifications tend to make the treatment far less effective, further skewing the risk/benefit ratio.

Dr. Kolar acknowledges the utility of ECT for certain populations but suggests that the risks of the treatment have been minimized. He writes, “There is no doubt that ECT is effective and life-saving for a selected population of patients. However, a good balance of sustained benefits and possible risks or serious cognitive side effects is not always reached.”

He suggests that better tools for assessing memory loss and cognitive impairment need to be used throughout the course of treatment, and that informed consent practices need to be updated to include the very real risk of permanent side effects.

 

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Kolar, D. (2017). Current status of electroconvulsive therapy for mood disorders: A clinical review. Evid Based Ment Health, 20(1), 12-14. doi: 10.1136/eb-2016-102498 (Abstract)

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Peter Simons
MIA Research News Team: Peter Simons comes from a background in the humanities where he studied English, philosophy, and art. Now working on his PhD in Counseling Psychology, his recent research has focused on conflicts of interest in the psychopharmaceutical research literature, the use of antipsychotic medications in the treatment of depression, and the general philosophical and sociopolitical implications of psychiatric taxonomy in diagnosis and treatment.

39 COMMENTS

  1. The action mechanism of electroshocks is not unknown: intracranial electrocution causes traumatic brain injury, that is the “effectiveness” and the ravages of the treatment. Electroshocks are a simple mutilation, visible after autopsy. Those who practice electroshock should be treated like excisers, that is, imprisoned without the possibility of escaping.

    Saying that electroshocks are good for some too depressed people is like saying that excision is good for some too sensual women.

    http://www.ectresources.org/

    • If you have had electroshock and now have memory and cognitive losses please see ectjustice.com. We are seeking people for litigation if you have had shock in one of these states, California, Georgia, West Virginia, Michigan, Minnesota, Florida, Rhode Island, or Washington D.C. Thus far a firm in California has signed people to suit.

  2. They did that electroshock to a young woman I was in the hospital with. There was no reason for it. Her only “problem” was she was very rebellious and promiscuous. She came back from the brain shock like this smiling zombie couldn’t even talk with us anymore.

    All these articles make it sound like the person ‘needs’ a treatment even if they are against the ECT

    • Shock has always been used more against women than men. In the 1950’s, important men in the community often had their wives hauled off to the local asylum if said wives were not doing and acting as their husbands wanted them to. And in the asylum they were shocked. So being a rebellious woman is reason enough to get you a good dose of electrified brain cells. Being promiscuous ranks right up there with being rebellious and would get you zapped as well. Shock has been used as a means of social control in much the same way that the neuroleptics are used to control social behavior. Nowadays it’s grieving older widows who are prime targets for this barbarous torture. Shock has absolutely nothing to do with “good treatment”.

      I was once at a meeting where the virtues of shock were being extolled to great length. I asked the young psychiatrist why it was that all other medical specialties worked their behinds off to keep people from having seizures while the specialty of psychiatry claims that it’s a treatment in good standing. I couldn’t believe it when he said that the seizures that psychiatry induces by shock are special and different from all other seizures!!!! I’ve never heard such tripe being propounded in public in my life and sat there amazed. A seizure is a seizure is a seizure, period. He then claimed that shock today is safer than it was in the 1950’s at which point I’d had enough and stood up and stated that this was not true. Using oxygen and anesthesia on people while you’re shocking them raises the bar for how much shock you must administer in order to cause the seizure so it’s actually more dangerous now than it was in earlier decades. Well, the entire room erupted in shouting and yelling, on the part of the psychiatrists there, attacking me from all directions. It was amazing. The emperor does so have a beautiful new set of clothes and no one better say otherwise. He is not naked!!!! It’s simply torture and nothing else.

      • “Using oxygen and anesthesia on people while you’re shocking them raises the bar for how much shock you must administer in order to cause the seizure so it’s actually more dangerous now than it was in earlier decades.”

        Peter R. Breggin says too: “modern ECT requires even stronger and more damaging doses of electricity”. If possible, I would like to have some sources on that.

        • Sylvain if you go here http://www.thymatron.com/downloads/somatics_brochure.pdf
          to an ECT machine manufacturer’s brochure and scroll down to the one-page advanced ECT course (!) it gives a list of electrical parameters.
          And here is a list for 1939-1973 from an ECT machine manufacturer (RJ Russell in England) writing in 1988 about how his machines have improved since early days.
          Assuming 300 ohm load
          pulse width 3ms
          peak voltage 198
          current amps 0.66
          frequency 100 per sec
          time 1 sec
          millicoulombs 198
          Wave form was sine, nowadays brief pulse.

  3. How many more studies before this lunatic barbaric assault causing craniocerebral trauma is banned?? Well, all the $ making shrinks need to do is point to the the lines it is great for “select populations” and there is no doubt it “has been lifesaving”.
    And, of course, we know that failing two “adequate trials” of antidepressants means a patient is “treatment resistant” and therefore a “candidate” for brain boiling shock.
    And then we have doctors like David Healy advocating for the use of ECT and claiming it’s hard to really “pin down” if memory loss is the related to ECT.
    There was recently an exchange on Twitter where Richard Bentall pointed out that the use of ECT was not “evidence based” and what followed were claims of how many prominent psychiatrists, including Allen Francis, would have ECT if they were seriously depressed and posts of the stupid Sherwin Nuland TED talk on ECT…there are shrinks who rabidly deny the damage that ECT causes- why? Because they are ignorant, uneducated, arrogant, or don’t want to give up their big $?
    The claim of “improved memory” after ECT is just pathetic.
    Why haven’t “real” doctors, including neurologists worked together to see this barbaric procedure is stopped?
    Big surprise that there have been no adequate tests of memory and cognitive function during or after ECT. The Janis studies in 1950 clearly showed ECT caused brain damage. Did that stop it? Over 60 years later, more studies…
    There is, as the study showed, no informed consent or warning about ECT in most cases.
    Why hasn’t a documentary been made about all the damaged ECT victims out there? Why has the media spent its time telling the story of kitty’s Dukakis’s miracle cute in ECT while ignoring the fact she shows serious signs of cognitive damage?

  4. “Treatment Resistant Depression” as a justification for brain shocks shows how “innovative” psychiatry can be by inventing a condition to explain away why their miracle drugs have not worked and thereby continuing to locate the problem “in” the person. As such the social factors contributing and maintaining the distress can conveniently be put in the “too hard to deal with basket”. I guess complexity has always scared psychiatrists a little bit

    • I always ask what we’d think of a car repairman who told you that you had “repair-resistant fuel injectors” but to pay them $300 and bring it back next week for another “treatment” to reduce the “symptoms.” We’d find another mechanic REAL quick! So how does psychiatry get away with blaming the people’s “depression” for “resisting” their efforts to be helpful? Wouldn’t it be a lot more honest to say, “Our approach didn’t work and we don’t know what to do to help?”

  5. It’s a controversial treatment because it’s completely despicable and often given involuntarily, so it not only causes brain damage, but severe trauma – it’s nothing less than torture. In Queensland, Australia, psychiatrists use it whenever they want, at the flick of a pen, and not as a last resort – even on children, the elderly, and those with a history of CVA. Psychiatrists in Queensland are essentially left to do whatever they like, and are not held accountable. There was a case four years ago of a patient at Royal Brisbane and Women’s Hospital who was given ECT 3 times in error before it was stopped by a relieving doctor as unsuitable – the patient did not even have a mental illness, but was misdiagnosed and given large amounts of inappropriate medications, unlawfully detained, and inaccurate information entered the medical records – an inaccurate medical and social history. The proper procedures were not followed to approve the treatment with the Mental Health Review Tribunal – all of this has been reported right up to the former Minister for Health and the current Minister for Health Cameron Dick, and to the Premier herself, Annastacia Palaszczuk MP – but no one has been held accountable, and it’s been left with the Office of the Health Ombudsman and the Queensland Ombudsman to cover-up in a complaints process which has taken over three years. You would think that the Palaszczuk government would never have heard of human rights abuses, but they certainly have, and stand by and do nothing. Involuntary ECT must be banned. No one would ever believe that this goes on in Queensland – most people don’t know this “treatment” is still used, and used involuntarily.

    • In England over half people given ECT are detained under the Mental Health Act. A few of them consent to ECT but most of them don’t. In total about 40 per cent of people who undergo ECT in England don’t consent. They are supposed to all be incapable of consenting. The law changed a few years ago so psychiatrists couldn’t give it to people who were capable and didn’t consent. Interesting information about Queensland.

      • In Queensland patients seek assistance voluntarily and then are usually placed under an Involuntary Treatment Order anyway, whether they satisfy the criteria under the Mental Health Act or not – usually as a “safety net” for the facility to cover itself in case anything goes wrong – it seems they haven’t heard of human rights in Queensland, Australia, yet. Mental Health Services in Queensland is very corrupt and are left to do whatever they like – it’s been like this for decades, surprisingly under a Labor government who are supposed to be more interested in social justice and human rights – at the moment it is the Palaszczuk Labor government. If anyone was capable of consenting to ECT but did not, Mental Health Services would just turn around and say that they suddenly did not have insight into the severity of their illness, and so place them under an Involuntary Treatment Order and then obtain authorisation for ECT. The Premiers grandfather’ even spent seven years in a German work camp in Poland during World War II, and still they allow human beings to be mistreated like this in Queensland. It is unspeakable. However, the Mental Health Review Tribunal has recently been referred to the Crime and Corruption Commission, and the President removed from his position. People are speaking out more. The Office of the Health Ombudsman under Mr Leon Atkinson-MacEwen and the Queensland Ombudsman under Mr Phil Clarke will cover-up the misuse of the Mental Health Act and mistreatment of patients in mental health facilities, and so will the Minister for Health, Cameron Dick MP. It a very corrupt and backwards State.

  6. People who have “consented” to ECT because of lies and misinformation are deeply traumatized when they discover they have lost 20 years of memories, are cognitively damaged, and have lost their careers. Being brain damaged by people you trusted to help you is deeply traumatic and with it comes self blame and anger at family members who did not know enough to stop the assaults.
    The FDA is still reviewing downgrading ECT devices to Class II- should they be looking at this review as they keep appeasing the lying APA and shock manufacturers?

  7. Thanks Peter for highlighting this article. I can only see first page but the author seems to being saying much the same as other psychiatrists. There is a bit about NICE guidelines in England but no mention of fact they are ignored. Maintenance ECT is used here. And I notice the author’s English hasn’t been corrected. Is it considered bad form nowadays to correct English or do journals no longer employ proof-readers or sub-editors?

    • Though interesting what he says about people reporting memory loss. The recent ketamine and ECT study in England asked four months after ECT how it had affected their memory – better, no change or worse. 3 said better, 16 no change, 18 said worse.

  8. Curious about whether there are new brainwashing “educational” programs for psych professionals about the alleged benefits of ECT. I had the unpleasant experience of running into this perky idiot of a psych nurse in line on Election Day. (November in the USA for all you in the UK, Canada, Australia, etc.) She went on and on about how great ECT was now and how it made depressed people happy. I got away from her as soon as possible. Dumb as a box of rocks and–I believe–dangerous from her stupidity. Just a few months ago I had overheard an almost identical conversation amongst some other psych nurses and technicians in a psych ward. Scary how stupid and gullible such sheeple are. But if they weren’t naive simpletons they would suffer horrible guilt at their cruelty or get fired. So of course only naive simpletons continue working in such places. (With a few exceptions. If you’re one of these exceptions let me offer my condolences at all the crap you put up with in “the belly of the beast!”)

  9. I wish you had engaged the simpletons you observed in conversation bc they are ignorant and dangerous and need to be informed.
    Yep, the pro-ECT propaganda is in full force and apparently being soaked up by the public also.
    Recently a stunned and uneducated jury found the psychiatrist who was accused of brain damaging renowned, 5 language speaking cardiologist Dr.Shaul Dadi with multiple ECT was NOT GUILTY. They bought the argument that his massive loss of memory and cognitive skills right after ECT was the result of depression and mental illness not multiple craniocerebral traumas! WTF?? When does that happen?
    This time the jury got it wrong, unlike the Stu Dolin Paxil case where pro -ECT shock doc David Healy pointed the finger at the devastating effects of taking antidepressant drugs.
    The scary part is these nurses are so stupid they believe the stunned muteness or the mild euphoria caused by the traumatic brain injury of ECT is a sign the patient is better, the depression is lifting!! And the shrinks love to pretend that is the case.

    • truth

      Exactly, the nurses think that the quiet smiling done by the “patient” shows how much better they are when in reality it points to traumatic brain injury. I can induce the very same behavior by smacking a person in the head a couple of times with a baseball bat but I wouldn’t call my behavior “good treatment”. Idiots without any humility who think they know absolutely everything. They need a couple of good whacks with a bat.

  10. I was made to watch a session of shock, I refuse to call it ect since this is an attempt to make what happens sound better than it is, when I was doing training in a large psych hospital in 1971-72. I was doing clinical pastoral education for chaplaincy work and the powers that be decided that my classmates and I should watch someone being shocked. Don’t ask me why they thought that this was necessary but they did. I stood all by myself behind a one way mirror and observed what took place. These were the days before muscle relaxers and anesthesia were used and it was absolutely horrible. I was already against shock because they destroyed my grandmother with it in the 1950’s early 60’s. Watching them torture this person with electricity was awful and I could do nothing about it to help the person.

    How dare them call this a “good treatment”. I don’t see psychiatrists or other clinical people rushing to get shock for themselves or their families.

  11. In 2016, I was “sectioned” after I attempted to end my life bc of despair over the loss of my cognitive abilities, my 31 year career, 15 years of memories, and the inability to form new memories as a result of 21 ECT I was given. My assigned “doctor” labelled me as “delusional” for believing ECT had harmed me, because she believed ECT was safe and effective and couldn’t cause that kind of damage.
    (The “doctor” who had continued to brain damage me with repeated Bilaterals for failure to “respond” is now the president of the Canadian Psychiatric Association. His “rate my doctor” reviews describe him as incompetent, dangerous, clueless, an epic failure, unsuited to work with human beings…)

    My “new” psychiatrist, clueless, incapable of listening, lacking in comprehension and empathy proceeded to order forced injection of antipsychotics to rid me of my “delusions” and suggested “more ECT” for my “depression”. Ignorant, uneducated, evil, and dangerous. The nurses were quick to insist I certainly had not suffered memory loss or brain injury from ECT.
    So, I was returned to the place that brain damaged and traumatized me and made me suicidal, only to be re-traumatized, assaulted, and threatened with more brain damage. Neuropsych testing I later arranged for showed a loss of 27 IQ points and serious losses in memory, executive functioning, math skills, problem solving, visuospatial perception, attention, learning new skills…

  12. Begging Madinamerica and everyone who writes for them and posts comments will refrain from using “ECT” or “electroconvulsive therapy.” Please, please call it electroshock instead. Many years ago, I heard the brilliant survivor of electroshock, Leonard Roy Frank, who suffered in devastating ways from electroshock, plead with people never to use the “T” or “therapy” in connection with electroshock. As Audre Lorde wrote, “We cannot use the master’s tools to dismantle the master’s house.” Using “T” or “therapy” is using the marketing term for electroshock and helping perpetuate the coverup of its dangers.