ECT- Living Better Electrically

I know two people who have had the treatment. One did well, it seemed to have no effect on the other.

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This hand, to tyrants ever sworn the fow, for freedom only deals the deadly blow, then sheathes in calm repose the vengful blade, for gentle peace in freedoms hallowed state. John Quincy Adams

AH, Cecil. Finally a topic I have more than a modicum of information about.
As a healthcare provider (ghastly euphemism) I've assisted in administering Electro-Convulsive Therapy (ECT) to at least 60 patients in the past ten years. Probably 600 episodes. I do have an opinion about this technique and that is that when it works it works great and when it fails, well, life sucks.
I've seen patients curled in the fetal position, unable to relate to anything or anyone, blossom into persons again. I've also seen tragic failures where probably no therapy would have resulted in a happier outcome.
In all cases, I have never seen any deleterious effects from the therapy itself. Transient confusion (resolving in a couple hours) and loss of memory of the event (the ECT and a few minutes before) were the most common side effects. Anesthesia always controlled the flow of events and assured the safety of the patient. A quick acting barbiturate was given via an I.V. and when the patient was asleep a rapid onset, short action neuro-muscular paralyzing agent administered, usually succinylcholine. The patient is now asleep, essentially paralyzed, and completely monitored. The anesthesiologist assure adequate respirations via a resuscitation bag and 100% oxygen.
The ECT itself is unspectacular. A previously inflated blood pressure cuff on the ankle kept the paralyzing drug out of the foot so we can monitor the the peripheral seizure by watching the toes twitch. An electroencephalogram (EEG) allows us to monitor the central seizure by watching the brain wave patterns. The usual seizure lasts approx. one minute. If the seizure continues for longer that anticipated, drugs can be given that stop the impulses. A common goal is to give between 500 to 1000 seconds of treatment over time. The patient MUST be closely monitored for clinical effect; no improvement is often not a reason to terminate treatment early on in therapy.

Wordy, but I hope this dispels some rumors and misconceptions. ECT is not a panacea nor an evil, just a tool.

Anyway, just what sort of things require a person to have such wonderful treatment Germ Boy? Also, can I get it done just by asking for it ?

Not that I'm a doctor (or even a healthcare provider), but if you're looking for a buzz or high I'd imagine you'd be disappointed.

Being used as a living electrical resister is seldom a pleasant experience.

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"I had a feeling that in Hell there would be mushrooms." -The Secret of Monkey Island

Shouldn't it be:

'Better living through electricity'

Anyway, just what sort of things require a person to have such wonderful treatment Germ Boy? Also, can I get it done just by asking for it ?
thx

I do have an opinion about this technique and that is that when it works it works great and when it fails, well, life sucks. <snip> In all cases, I have never seen any deleterious effects from the therapy itself. <snip> ECT is not a panacea nor an evil, just a tool.

Shouldn't it be:
'Better living through electricity'

Anyway, just what sort of things require a person to have such wonderful treatment Germ Boy? Also, can I get it done just by asking for it ?

I was wondering when folks were going to get around to the Reddy Kilowatt lines . . . I'm just glad somebody else went first.

I've known two people who had ECT . . . both highly intelligent, creative people who happened to have "nervous breakdowns."

The first one, a former librarian with a master's degree from Emory University, wound up with the approximate IQ of a 10 year old. She was so jolted from her experiences that she never recovered and lived the rest of her life as a perpetual child. She was sweet, she was innocent . . . and she lived like 50 years in that condition. It was too sad. In fact, it contributed to her demise; she let a stranger into her house, never dreaming that anybody would ever hurt her. He raped and killed her, but she was really killed all those years ago.

The second person I've known was a jazz pianist. Not only does he have no memory of his treatments, he has very little short term memory . . . or long term, for that matter. Which is an inconvenient thing for someone that made their living by playing stuff out of his head. I wish I had a penny for everytime I've played with him, gotten nearly through something . . .and he stops . . . and says, "I can't remember the rest of it." He can't remember people's names when he meets them, has "blanks" when he forgets things . . . It's heartbreaking.

ECT probably helps as many folks as lobotomies and in the same fashion -- you're a better person in society's eyes when you're quiet. The reference to "One Flew Over the Cuckoo's Nest" is most appropriate, see what happens to troublemakers?

ECT has been mostly discarded as a treatment but recently it has made a comeback, though I can't imagine why. My guess is that people are desperate for a quick fix, a cure; treatment modalities like drug therapy and psychological couseling are not always helpful and take too long. I have also heard that insurance companies will actually PAY for ECT, mostly because it's something they can do that's quick, cheap, and easy.

And why would you WANT something like this?

your humble TubaDiva
who reminds you that there's better ways than "shaking hands with Jesus."

Mother Nature gave me two treatments for free. I do not look forward to a third. I may not be lucky enough to survive. I had not thought (?) to use this as an excuse for my strang behavior though. Humm I wonder if the police would............ <-- 3¼¢

I don't know about the rest of y'all; however, I'm still wondering about Germ Boy's use of the terms "100% Oxygen" and "assure the patient's safty" to describe a procedure which is basically electrocution

I think this thread is revealing in that the myth persists that ECT is inherently bad and that its use is somehow cruel. First, (ooo, those flames are close) it HAS been used inappropriately used in the past, for punitive purposes mostly. Second, its true mechanism of action is not completely understood (neither is the effect of aspirin for that matter) so its use could be labeled suspect. Third, it's not the first line treatment for any disease.
All the patients I worked with had been in treatment for their mental difficulties for some time before the option of ECT was even broached; we didn't even think of it until many other regimes (chemical) had been explored. This treatment ain't for everybody.
COncerning the 2 "failures" outlined above, what other meds were, or are, the librarian and pianist on? What is their psychiatric disease? Are they currently in therapy? The questions abound.

Again, ECT is a tool. As such, the skill of its user is the greatest determinant of success.

Again, ECT is a tool. As such, the skill of its user is the greatest determinant of success.

You go first, okay?

As far as any prejudice I might have, well, I've seen such marvelous use of this tool I'm not likely to be pro-shock therapy any time soon. I saw real suffering (and in one case, real death) because of it and that's no myth.

your humble TubaDiva

Death?!
Was this a case of gross malpractice, or does the legal waver cover a ride on Ol' Smokey?

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"I had a feeling that in Hell there would be mushrooms." -The Secret of Monkey Island

"I saw real suffering (and in one case, real death) because of it and that's no myth."

I do not doubt your veracity. I am interested to know a least a couple details of this incident.

I am not beating a drum for ECT but do believe that peeling away the veil of mystery surrounding any procedure allows better decisions.

BTW, I would submit to ECT only after many other avenues had been traveled and turned out to be dead ends.

All things considered, this thread can go many pages in the effects and controversy surrounding ECT … and still be barely the outer layer of the “onion” of this topic.
What is perhaps topping the “bothersome” factor is somehow still hidden from public knowledge…

- Such as who owns the company that makes the ECT machines, and the influence on the use of the procedure…

- Also, the only state that requires tracing the statistics and patients is Texas… with numbers being thrown around that significantly misrepresent the success and the risks…

- The profit and professional incentive in using non-surgical techniques to treat people.

-The statistically significant (extreme is a better word) rise in referrals for ECT when patients qualify for Medicare

-The very short term (less then a month) that “successful” treatments have relapsed into their illnesses

ON the flip side…..

-Case studies of people who spent so many years (unsuccessfully) with drug and other therapies.
-Misrepresentation of memory and behavioral side effects by opponents of ECT

Personally---- I find this is the rare subject that I cannot have a discrete opinion on…

I was fascinated when I studied several chapters of “great and desperate cures” in December, ’98 , while researching the history of lobotomy . I agree with Unka Cecil’s recommendation of this book… it was very “eye opening”.

For those that are still paying off there Straight Dope bills at the local bookstore… or find Dr. Valenstein's
Book very hard to find or order… a web site has acquired permission to post the book on his site for research and knowledge. web site has acquired permission to post the book on his site for research and knowledge. The following site also has several other mind boggling articles on this subject:

http://public.carleton.edu/~vestc/text/gdcindex.html

for a statistical look at ECT , here is another link that is good foo for thought.

http://www.usatoday.com/life/health/lhs188.htm

As a nursing student, I spent one horrendous day helping to give ECT treatments. The worst part, for me, was getting the consent form signed. Here's this poor elderly woman souped up on God knows how many drugs and I'm trying to read her this form. She told me she didn't want it done. I went and told the nurse, who talked to the woman for about five minutes and came back with the signed form. The old woman cried until the minute the paralytic took effect. She was a delusional mental patient; nobody took her seriously when she tried to protest. I wonder how many people are coerced into getting ECT?

She told me she didn't want it done. I went and told the nurse, who talked to the woman for about five minutes and came back with the signed form.

Holly, your point is well made and important. But the bigger evil you refer to is the fact that patients (clients, customers, whatever) are coerced into treatments or regimens everyday in this country. That it was ECT that yout patient was forced into agreeing to is irrelevant. In my 20 years of practice I have always rigorously defended a person's right to self determination. For any procedure where informed (key word) consent is required that has to be the overriding principle. I've known patients who have thoughtfully declined "lifesaving" treatments who have kept on living. I've also seen people who needed emergent treatments but because of an incapacity to make their needs known, have suffered while proper consent was obtained from a NOK. Your example is an egregious one and deserves to brought to light. A person on psychtropic meds must always be critically evaluated for their ability to make clear decisions.

Abuse is a part of the human condition and the caring professions are not immune. Please be bold and remember that at times you may be the only advocate that a patient has.

Okay folks, this is one I can actually field with some small knowledge. First a bit of background. I'm a neuropharmacologist who has specialized in the study of antidepressant treatments since 1983. Antidepressant drugs have been on the market since the mid-1950's and ECT since the mid-1930's. For the record, antidepressant treatments have been discovered either a) by accident or b) by copying effective treatments in a patentable way. Despite a boatload of work (my own included), we still don't know exactly how *ANY* antidepressive treatment (psychotherapy, drug therapy, ECT or chocolate) works.

That said, antidepressants work at about the following rate: Psychotherapy - 50-60% (higher in some cases), Drug treatments - 60-70%, ECS - 90%. The down-side is that depression is a *VERY* dangerous disease. It accounts for about half of the cases of suicide and even in those patients who aren't actively suicidal, it greatly increases risks for everything from immune dysfunction to heart disease and automobile accidents.
Unfortunately, antidepressant drugs, especially the 1st and 2nd generation can be very toxic. So much so that before the arrival of the 3rd generation serotonin reuptake inhibitors like Prozac or Paxil, it was condidered very risky to give a patient a large prescription because of the ease with which that prescription could be used to commit suicide. Luckily, The 3rd generation drugs are much less risky and much more tolerable to patients.

HOWEVER, like their predecessors, it take up to 6 weeks of continuous treatment at the correct dosage to produce a real antidepressant effect. Since the success rate is modest (60-70%) and inconsistent from drug to drug (i.e. some patients will respond to Prozac but not Paxil while others to Paxil but not Prozac), it can be discouraging to the patient if not downright dangerous (because of the risk of suicide during those 6 weeks) to use medication. In contrast, response to ECT is very rapid, taking 7-14 days to produce effects. Moreover, those effects are observed even in patients who are very unresponsive to drug therapy.

LASTLY, older people are much more likely to develop toxic responses to antidepressant drugs or be at risk of dangerous drug-drug interactions (e.g. with heart or blood pressure meds).

All that being said, ECT becomes the antidepressant treatment of choice for reasons such as: 1) speed of response; 2) failure to respond to 3 or more drug treatments or 3) toxic complications from drug-drug or drug-fetus effects. (This last accounts for the higher than usual use of ECT with Medicare patients since ECT is more often used in the elderly). ECT is *NOT* used as a punishment except by incompetent psychiatrists.

There is no doubt that ECS can produce memory problems in about 5-10% of patients. However, permanent damage is rare - less than 1%. Contrast that with toxic effects from medication or untreated depression that can run as high as 30% depending on who's counting. And by the way, many of the horror stories that proliferate are either of the "urban legend" type or assume that the long term damage was produced by ECT (rather than the psychiatric disease itself, by the anesthesia used or by other drugs the patient is/was taking.

Sorry to be so long-winded but, I am after all, a professor -- it's what we do.

I'm a former teacher and registered nurse, totally and permanently disable by 13 out pt ECT's I had in 1983. The damage ECT did to my brain is verified on numerous EEG's. My disability is based upon this brain damage.

Less than a year prior to the ECT of 1983 I had graduated with honors as an RN at age 40. Withinin 6 months of the ECT I was officially diagnosed as "dementia", "organic brain syndrome" and "diffuse encephlopathy". The most profound damange is in the *direct path* of the electrical current, in the frontal and temporal lobes, as well as the limbic area of my brain.

Fifteen to twenty years of my life were simply "erased". Only a few bits and pieces have returned. I have serious cognitive impairments, all verified as a result of the brain damage induced in the name of "therapy."

I belong to a group of over 500 shock survivors, who have permanent memory loss and cognitive impairments due to their "therapy." Many of former professionals were unable to work (at all) after ECT.

The death statistics from Texas, which have been compiled quarterly for nearly 6 years now, show a death rate of 1 out of 200. This means 1 of every 200 persons receiving ECT in Texas is dead within 14 days of their "treatment" or "therapy."

California has kept records of memory loss for over ten years, and lists permanent meory loss as a *complication* (not temporary side effect) of ECT in alarming numbers.

I have spoken to approximately 200 shock survivors over the years, who have been disabled and devastated by ECT.

ECT took my past, my profession(s), my ability to work and learn, my musical abilities, who I was, and the mother of my children.

I call ECT evil, and a rape of the soul.

Anyone wanting more info on ECT will find it at www.ect.org or http://members.aol.com/wmacdo4301

What exactly does ROIZ mean by ''misrepresentation'' re:memory effects?
Also, as the primary author and llanfresh illustrate, the concept of being an ''expert'' in this subject basically boils down to knowing about the mechanics of the procedure as opposed to it's effects even though claims are made to the contrary. This is directly comparable with a nazi deathcamp gas chamber administrator giving a description of the mechanics of dropping a canister of Zyklon B crystals in to the showerheads and then claiming to know what it is like to be asphixiated by the gas.

By definition the only people who can legitimately claim to know about the effects of ECT are those of us forced to have it. The effects upon my memory were not transient nor are they misrepresentative of the truth. The effects on memory are just the start, however. Other effects come into play. Facial recognition difficulties, right/left confusion, word and number dyslexia, etc, etc, etc.

Why take my word for it. reinforce your ''expert''status with a dose or ten for yourself. Until then do not ''profess'' (literally) to know what you are talking about.

Let me clarify a few things about my earlier comments.

First - I do not support "enforced consent" unless the patient is realistically dangerous to themselves or others. Nor do I suggest minimizing the potential side effects or complications. Both are negatives in deciding on electroconvulsive treatment. However, side effects and complications exist for *ANY* medical treatment - not the least of which includes antidepressant drug treatments. In either case, the negatives have to be considered *WITH* the possible/probable benefits.

That's obviously a judgement call but, it's one that has to be made by patients, family, patient advocates, physicians, etc. Like any other judgement call, there is the terrible possibility of being wrong - sometimes disasterously so. For most patients, however, the judgement to use ECT results in relief of depression without severe side effects.

I do not dispute the fact that ECT *CAN* and *HAS* resulted in severe memory damage for some patients. However, there is not a single medical treatment that does not have its horror stories -- even antibiotic treatments have been known to kill people. Until we have better treatments, we have only two choices: abandon all potentially risky medical treatments (which ends up being the abandonment of *ALL* medical treatment) or accept, inform and try to reduce the known risks.

And by the way - Neither GermBoy nor I am trying to suggest that we know what your personal experience of ECT is or was like. I would trust your own assessment of that just as I would expect you to trust mine. Your bad experience makes ECT a bad choice for *YOU*. It does not make ECT a bad choice for everyone.

[[First - I do not support "enforced consent" unless the patient is realistically dangerous to themselves or others. ]]


Great expression -- I assume they smile when they say that.

Ilamfresh- "I do not support...unless", is about as meaningful as saying a Nazi does not support genocide unless you happen to be a Jew, a gypsy or homosexual. You either support the patient's right to say "no" or you are a part of that abusive system. Since when has ECT been recently used in "third part risk" patients? Most of the shrinks I know now declare that the target group are depressives. There is a tiny, itsy, bitsty little difference between mainstream medicine and pschiatric care provision. In all other areas of medicine the patient, (with minors, the parents) decides if to take the risk. Some, indeed, decline medical intervention at the risk of their life, sometimes for religious reasons. Life at any cost, however, seems to be the theme for American psychiatrists, who just happen, by coincidence of course, to make a metaphorical "killing" out of the profits of exposing their patients to the risk of shock. Yes, antibiotics can kill. Thing is, unlike shock, there is statistical evidence that they save lives. Also, of course, no-one is forced to take antbiotics.

ABithell - This may be a nit pick, but your statement "no-one is forced to take antbiotics" is not true. People with tuberculosis and other highly contagious diseases can be forced, if necessary, into quarantine until medical treatment is complete. In these cases the threat to the public (epedemic) outwieghs the individual's rights. In no way am I advocating forced ECT, just setting the record straight.

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Beware the lollipop of mediocrity. Lick it once and you will suck forever.

Okay, I know I should probably let this drop but, I hate being criticized by misquoting.

1. There are in fact, occasions when a patient's right to say "no" to treatment are superceded by the public's right to protection from the patient's disease -- whether that is infectious or psychiatric disease. As an extreme example, I don't think most people would object to quarantining a person infected with Ebola Zaire (or a similarly infectious and dangerous disease) -- whether or not that person objected. It is not a matter of "us right, them wrong" it is a weighing of risk to patient vs. risk to population.

2. I do not advocate ECT except as *ONE* option for the treatment of major depressive disorders (See my first post).

3. The evidence for the effectiveness of ECT in the treatment of major depression is pretty darn strong - 90% or more of people treated show evidence of significant remission of depression. This is validated by *BOTH* "blind" third party raters and by patient self-ratings. These results are even more impressive when you consider that the patients recommended for ECT usually have not responded to 3 or more drug treatments.

4. Please be a little cautious in tossing around comparisons with Hitler et al. Even if your comparison were valid on the grounds of means or result (which it most certainly is not), it is invalid on the grounds of motive. ECT is used as a *therapy* of last resort -- Not as a sadistic implementation of a "Final Solution" for obstreperous people. To suggest otherwise is demeaning to the 10+ million victims of the Holocaust and their families.

So now we got two ''experts'' ganging up on me eh? Good, that's the way I like it.

1. Mr.Jackson, I think comparing the abused ''mentally ill'' to removing the rights of Typhoid Mary is really clutching at straws, certainly, as you say yourself, ''picking nits.'' Real doctors support the concept of ''first doing no harm'', and rather than picking nits, would support a line of argument that seeks to protect the vulnerable.'' Hence the ''Mr''.Sorry, but you suck as a doctor.

2. llamafresh, at least the above mentioned individual has the guts to identify himself in his username. Would you like to do likewise? The comparison with the Nazis is more appropriate than perhaps you would like known. Who do you think carried out, many with enthusiasm, the obscene orders of Hitler re: the ''mercy'' killing of mentally handicapped children, one particular beast keeping the brains for later study? DOCTORS, FREQUENTLY PSYCHIATRISTS, that's who.

Funny how the right wing of medicine frequently describe the most violating of ''treatments'' as ''mercy-based'' or ''life saving''.

You may know that even The Royal College of Psychiatrists, (UK), who are still pro-forced shock, released the Benbow Report last year where they admitted that TWENTY FIVE PERCENT of psychiatrisys giving shock had seen DEATH OR SERIOUS CONSEQUENCES arising from the application of shock. I can send copies to anyone interested. The medics are having a bit of a time over here explaining that one away and changes in the law are expected.

So, just because mommy and daddy had the dollars to send people with white coats and numerous letters after their name to college don't mean they have the monopoly in the genius stakes. Given enough time and cash, you can teach a horse to count.If you then give him a job in ''WE SAY SO DRUG CORP.'', he might even be able to dole out pills.

You can't buy the ability to be humane however. Or honest.

Well, ABithell, we do seem to have a bit of a temper.

1) Rule number 1 online is NEVER take a screen name at face value. Had you bothered to check my user profile, you would see that the main reason I "suck as a doctor" is that I am a banker. Damn good reason if you ask me. I have reiterated this point in numerous posts in other threads, but you only seem interested in reading this one.
2) I did not compare the rights of the mentally ill to the rights of the physically ill, you did. I simply pointed out that your comparison was flawed.

I have no current stake in the ECT debate, and I chalk up much of the "information" in this thread to opinion - even if it is opinion based on personal experience. But if you represent something as fact on this board, such as your "no-one is forced to take antbiotics" quote, you had better be able to back it up. Perhaps if you had read the last sentance in my previous post, you would have understood.

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Beware the lollipop of mediocrity. Lick it once and you will suck forever.

Okay, AB. Since your last message was almost entirely given over to personal attacks, I am going to sign out of this thread. If you want to avoid discussion by using insults, that's your choice - but, I don't choose to participate.

I would only observe that the Benbow Report *did not* conclude a 25% death or damage rate from ECT but rather a 25% overall side effect rate. That's about the same or less than the overall side effect rate of most antidepressant drugs. In fact, the death rate with ECT is actually somewhat lower than the drugs because of a reduced rate of suicide in ECT treated patients.

It's fine to take a stand AB but, at least get your facts straight and don't try to make your case with strawman arguments based on misrepresentation.

[quote]TWENTY FIVE PERCENT of psychiatrisys giving shock had seen DEATH OR SERIOUS CONSEQUENCES arising from the application of shock.]/QUOTE]

Specious argument at best. 100% of cardiac surgeons I know have seen death or serious consequences arising from the performance of coronary artey bypass graft (CABG) surgery. Some of those surgeries have been performed on patients who barely understood English let alone the possible consequences. Should we not condone it because it is an incredible cash cow for docs and hospitals?

ECT is not inherently evil. Heart surgery is not inherently bad. Their application to humans can be, however. Don't dismiss any therapy out of hand because of public mis-perception or hysteria. And don't ever assume that your doctor is a genius just because it says M.D. after his name. Be aware of risks and be ready to stand up for yourself or loved ones.

This thread has mutated from the original context but still has some good points and cogent ideas.

I stand by my opinion of ECT: a useful tool when applied appropriately. Nowhere in that opinion is the approval of using ECT frivolously or punitively or giving treatments to persons not aware of the consequences.

Llamafresh. Quite simply, you do not know your facts. Anyone wanting to verify that this guy does not know what he is talking about should contact either the Royal College of Psychiatrists in Belgrave Square London, or the UK Psychiatric Bulletin. The full title of the paper concerned is ''Electroconvulsive therapy practice in north west England, by Susan M. Benbow, David Tench and Simon P Darvil.'' ''Twenty-Five percent had experience of death or serious.....''This is a 1994 study, not 1944, 54 or 64. Published in 1998.

As to the Banker, well I hope the next stock market crash sends you to a pro-ECT shrink, as, judging by your username and evident interest in things medical, you may well have frustrated ambitions that you could do with curing by actually sampling the goods for yourself. As you said yourself,a nitpicker.

One thing that the pro-shock camp cannot stand is informed debate. The arguments cannot stand the light of day.

I'm still waiting for my memory to come back, and I'm celebrating the 1st year anniversary with lots to drink (after writing 3 term papers over the weekend). Still waiting for those wonderful effects from ECT to come back that persuaded me to do a tap dance for the kids and instructors at the medical school across the street while receiving those treatments (but for the life of me can't remember what I said). Anybody want the baby grand I can no longer play, having lost my "musical ear" and ability to read music after being shocked 6 Xs? I'm not giving it away free, though. When I figure the damage I suffered from receiving these great treatments, the damage it caused to my skeleton and joints, and any new surprises that'll cost me money. . . whatever I could've gotten if I had the money and guts to sue. Golly gee, I lost more memory with 6 ECT treatments than I did after the car accident I was in resulting in a depressed skull fx.! Post ECT I am now "abusive," "non-cooperative"--a whole new me! Marvelous tool, that ECT. Professional, legalized Russian Roulette (and I didn't say the "N" word).

I don't know what sort of a doctor can inflict repeated electrical closed-head injuries, and not recognize the signs of
organic brain syndrome. If all so-called mental illnesses are supposed now to be brain disease or brain disorders then these idiots better get some training in elementary neurology. These sub-rate physicians are simply mistaking the euphoria and confusion of brain trauma and memory loss for improvement of so-called mental illness.
It's an unforgivable scam, on a collossal scale, it's as simple as that. No study has ever shown any lasting antidepressant effect from ECT. It's a high price for the survivor to pay, when brain damage is such a distinct possibility, if not probability, for a few weeks relief from overburdening emotion.

----- excerpted from a recent survey done of 500 electroshock (so-called) patients -----

This survey can be found at url http://members.aol.com/wmacdo4301/electro/papers/equest.htm

What do a nuclear physicist, a chef, a Royal Marine commando, a plumber and 7 nurses have in common?

Answer: They are all linked by the same experience — powerful electric shocks through their brains that left a legacy of profound after-effects.

And these are just a sample from literally hundreds in our files — all shocked, not accidentally, but deliberately, by doctors who assured them it was a safe and effective way to cure their mental problems.

They have never met each other, yet again and again they describe similar effects that have disrupted their lives, ended their careers and left them with dull and blunted minds.
They ask:

why do I feel like a robot?… why have I no feelings any more?…
why am I so fatigued all the time?… why can't I remember day to
day things like I used to?… are others as scared as I am of visiting the doctor?

After first hearing of us, many spent weeks gathering the courage to ring and tell their story. Some spoke for hours, relieved beyond measure to find at last someone who understood and believed what they were saying. Many felt they had been "mentally raped".

Here's an interesting "what if" for everyone to chew on: What if John Coltrane had not been sprung from Bellvue Hospital before the doctors scheduled his ECT treatment?

My supposition: If Coltrane had been given ECT, the Jazz lexicon would by shy many works of genius.

Fact from an NPR show on Coltrane I heard last year: Upon learning that Coltrane was scheduled for Electro Convulsive Treatment (known then as "Electroshock"), his private shrink got that man the hell out of Bellvue. This is not just a fantasy from a critic of unquestioned psychiatry. This is factual information availiable from medical records as well as biographies on John Coltrane.

No disrespect intended for anyone. You want facts, I give facts. Any opinions and suppositions I offer are listed as such. Consider carefully and draw your own conclusions.

One last question: if your computer was having a problem with it's hard drive, would you fix it by driving a power surge through the circuitry? I sure wouldn't. For some reason, the inventors of ECT who did not know anything about physical models similar to the human brain must have figured that the best way to "initialize" a human brain would be the equivalent of passing a power surge through it. Fortunately, the human brain is a lot more complex than a mere motherboard and hard drive setup. Unfortunately, a brain is not replacable.

I refuse to get emotional about this debate. Rather, I would like to encourage reasoned discussion. I also refuse to flame others as flame wars just show who can pee the farthest. I will respect the dignity of everyone here, no matter how much I disagree with those I see as bankers who dabble in subjects unrelated to banking and psych techs who have seen too much and only talk to their own kind to share notes. (I apologize I am offending anyone. That is not my intention here.)

We all have much to learn from each other, and at least I know whom to ask concerning investments or observations on working in a psych ward. In all professions, there are "angels" as well as "devils"--I use these terms broadly. Yes, tools themselves are neither good nor evil, but the ones who use those tools can fall under either one of those two catagories. Consider the phrase "the banality of evil" and the quote, "The only thing that allows evil to flourish is for the good to do nothing."

Considering the broad spectrum that we all carry within us, all of us are a step away from either good or evil. Many times, we do both at the same time. Being human is never easy, meaning that we all make mistakes. I just hope that I am never on the receiving end of an ECT "mistake."



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Rightly to be great is not to stir without great argument, but greatly to find quarrel in a straw. --Hamlet

I've got several things to say about ECT, from both personal and professional experience. I'll separate the two into separate posts.

First, just a brief note about myself. I'm a journalist who has specialized in medical/science writing (even before I was shocked myself), and I am a member of the Federal Task Force on Electroconvulsive Therapy.

I have also done several independent research studies on the topic of ECT, some of which has been cited in US Government documents (the recent CMHS Task Force Report) and in Australian reports.

I was given ECT in 1994.

My family was told that it would be unilateral (one side of the brain), memory loss was simply propoganda from anti psych groups and didn't exist, and that it would cure my depression.

I was coerced into it by my psychiatrist.

I was not given unilateral, but bilateral, and have since learned that although unilateral is talked about quite a lot (it doesn't have as severe memory loss/cognitive disturbance), bilateral is what's used. Psychiatrists know that in severe depression, unilateral isn't very effective (some studies put it at 16 percent effectiveness).

I lost two entire years of my life. There is no possible way that it was NOT a result of the ECT. I had the memories before the treatment, and afterwards, they are gone. I'm still waiting, but they haven't come back.

I also have some cognitive damage, mostly the math side of my brain.

And, the ECT had no effect on my depression.

Okay, GermBoy is now thinking, well, we all know there's a horror story for every treatment. Unfortunately, with ECT, there are many thousands of horror stories. I get about 50 emails a day from people who have lost memories, or they have a loved one who doesn't remember their name and cannot function anymore.

And in my research, I've spoken to thousands who have been damaged by this treatment.

I could deal with it if I was a freak incident. These truly do happen in medicine. But this kind of memory loss and cognitive damage is not a freak occurence. It happens with regularity, and the patients are then poo poo'ed and told to get over it, that they're mistaken or lying. That compounds their feelings of victimization, of having been horribly deceived.

Talk to any survivor of brain trauma, such as a car accident, and you will find striking similarities among them, and ECT survivors.

GermBoy asked:

>>COncerning the 2 "failures" outlined above, what other meds were, or are, the librarian and pianist on? What is their psychiatric disease? Are they currently in therapy? The questions abound.<<

Perhaps I've misunderstood your intent, but it certainly seems that you're indicating the two cases cited were freak incidents.

They are not.

I talk to people like this everyday.

From Germ Boy:

>>>As a healthcare provider (ghastly euphemism) I've assisted in administering
Electro-Convulsive Therapy (ECT) to at least 60 patients in the past ten years. Probably 600 episodes.<<<

One of the things I've come across over and over in my research is this very thing. You administer the ECT, and the person is doing better.

Of these 60 patients, how many have you talked to, say, 6 weeks down the road? 6 months? A year?

One of my theories on why psychiatrists (and other health care workers who participate in administering ECT) are so convinced that ECT is a miracle cure and there are no bad effects is that they see the patient during the hospital stay, as they receive treatments.

The patient is then released...a number of patients relapse, or are angry that they've lost memory, and they find a new doctor. The doctor who performed the ECT actually in many cases DOES NOT KNOW that s/he's damaged someone.

GermBoy, can you cite any study that shows long-term benefit of ECT? There are none. *No study* can show any benefit beyond a few weeks. ECT may provide temporary relief from severe depression, but at what cost? Is two years of one's life worth four weeks of euphoria?

Those who suggest that ECT works by way of head injury have pretty good evidence from this particular set of effects...a series of treatment, followed by euphoria and confusion...then in a few weeks, back to depression once again...minus some memories.

Someone wrote:

>>>In contrast, response to ECT is very rapid, taking 7-14 days to produce effects. Moreover, those effects are even in patients who are very unresponsive to drug therapy.<<<

Again, the rapid response is usually followed by a rapid relapse. And one of the predictors of a poor response to ECT is a poor response to drug therapy. Yet those very patients are the ones pressured into ECT, even though studies are beginning to show that if drugs don't work, ECT is likely not to work as well.

>>
There is no doubt that ECS can produce memory problems in about 5-10% of patients. However, permanent damage is rare - less than 1%.<<

Only a few states in the United States require any kind of record keeping with regards to ECT. California is one of those few, and if you look at California stats (kept by their Dept. of Mental Health), you'll see that the above statistics are total hogwash.

>>>And by the way, many of the horror stories that proliferate are either of the "urban legend" type or assume that the long term damage was produced by ECT (rather than the
psychiatric disease itself, by the anesthesia used or by other drugs the patient is/was taking.<<<

The horror stories are not urban legend, and I am horribly offended that you would chalk up people's disastrous experiences to a joke.

But it's a lot nicer to just say they're making it up, or they're confused..it was really the disease that caused the memory loss.

Shame on you...you invalidate the lives of so many people.

Juli,
I don't think that ECT is necessarily touted as a long-term solution for depression. Meds (SSRIs, MAOI, etc.) are long term solutions, but ONLY because they are must continually administered. Stop the meds (not advisable) and the effect goes away, sometimes precipitously. ECT has some similarities in that it's effect DOES diminish after the treatment. Repeat treatments are an expected part of the therapy. Anyone who was told "One zap and you're better" was lied to. That sucks but it is a different issue.
I have had contact with most of the patients that I knew from their ECT experience. Some have said "never again" others say "it gave my life back" and another segment feels equivocal "Take it or leave it". Truthfully, most fall into the take-it-or-leave-it group. So, what should I do? (BTW I no longer am involved in the treatments; no dilemma just different job).
It clearly helps some and very likely hurts others. Is it my duty to disallow IT? Should there be state sanctions against it? Welcome to the world of tough questions w/ murky answers. Dialogue like ours is good as long as the flame level warms but doesn't singe. To close, I take every persons complaints and problems as real. To minimize anyone's experience is anathema to me. I've found it difficult at times, but I don't expect to be canonized anytime soon.

GermBoy
I find it "unusual" and quite frankly unbelievable that you had contact with most of the patients that you knew who you assisted administering ECT to. Generally when people have ECT, they don't go back to who admiinstered the ECT a year or two later and disucss their memory loss, cognitive impairments, and sometimes (as in my case) back problems from a fracture of a thrasic vertebra or jaw.)

Nor are there "look back clauses " in any of the 4 or 5 dstates that have any sort of laws regarding ECT. The state of Texas has had a reporting law for 5 and a half years, requiring reporting of deaths and has brought to light the fact that approximately 1 out of every 200 persons who receive ECT are *dead* within 14 days of their "therapy."
The state of Illinois is the only other state requiring reporting of deaths within 14 days of ECT, however, since this law was passed just over a year ago, I have no stats from Illinois.
California has reported permanent memory loss in alarmingly high numbers as a *compolication* (not a side effect) of ECT.
I don't believe anyone has implied that you should "dissalow it" (ECT) nor do you have the authirity to do so on a state or national leve.
I feel any responsible "health care provider" or professional would support and encourage state legislatures to at least pass reporting laws, requiring reporting of deaths, complications, and also having a look back clause questioning patients RE memory loss and cognitive impairments at 6 months and year after ECT.
Instead (and I have been present in a state legislature to see this myself) health care providers/professionals, members of the APA, are opposed to such laws.
To say that ECT "hurts" some persons is a gross understatement. To say it disables and brain damages them (and kills others)more accurate. Damaging the brain, particularly the temporal and frontal lobes, erasing years of memory and causing a person to lose his profession, often his family, and his very identity of who he was as a person is not what I consider simply a "hurt"....I consider ECT evil, particularly because it is done under the guise of "help."
I "hurt" my foot last week, and a number of years ago my ankle (fracture), burned myself when a cooffee pot exploded. These "hurts" all have either healed or left a manaageable after effect.
ECT did no simply "hurt" me. It destroyed who I was, and took the mother of my children.
ECT damaged my brain, and EEG's verify this.
A couple of months ago a friend of my adult son phoned to say his grandmother was in a psychiatric hospital. My son told his friend "I met your grandma...shes' a nice lady..if they are going to give her shock treatments, do the kind, the merciful thing...get a 45 and blow her brains out."
That is the perspective of an adult child of a mother who had ECT nearly 16 years ago.

Barb,
I'll not dispute nor minimize anything you bring up.
I HAVE had contact w/ a great many of the previous ECT recipients because of the peculiarities of the chronic psych units in this hospital. I stand by my observations.

A couple of months ago a friend of my adult son phoned to say his grandmother was in a psychiatric hospital. My son told his friend "I met your grandma...shes' a nice lady..if they are going to give her shock treatments, do the kind, the merciful thing...get a 45 and blow her brains out."

Please, don't tell me this is resonable response in your eyes. If so then your willingness to polarize your opinion makes discussion difficult.

To one and all,

I had decided to leave this thread but thought that some of the subsequent messages were very interesting. I was particularly interested in the argument by several people that ECT has a very high death and injury rate. Since my last intensive look at the ECT literature was about 5 years ago, I decided to check the recent publications.
What I noticed was that almost all of the published material on the damage attributed to ECS was anecdotal literature -- that is, case reports. Case reports have been and are the natural stimuli for scientifically rigorous studies of an hypothesis. However, in any area of medicine, case reports cannot be used for generalizing because they depend on studies of a single individual's response.

Those studies that included a large group of people studied for at least 6 months each found survival rates after ECT were actually higher at follow-up than patients who received only antidepressant drug treatment (Philibert, RA et al, J. Clin. Psychiatry 56:390, 1995). In fact, the Texas retrospective study that I found (Reid, WH et al. J. Clin Psychiatry 59:8, 1998) indicated a mortality rate of 8 in 2583 patients. Of these, 5 of 8 were clearly unrelated to ECT itself (3 accidents, 2 fatal anesthetic reactions).

The most thorough study that I found of the effects of ECT on brain structure (Devanand, DP et al, Am. J. Psychiatry 151:957, 1994) concluded that they observed no evidence of ECT-induced brain damage in the sample of patients they examined.

There is also evidence that pre-ECT cognitive state is a strong predictor of post-ECT retrograde amnesia (Sobin, C et al., Am. J. Psychiatry 152:995, 1995). That is, some (certainly not all) of the severe memory problems after ECT may be due as much to underlying organic brain disease as to the ECT itself. As far as other, non-memory-based cognitive effects, Calev et al (Calev, A et al., Br. J. Clin. Psychology 34:505, 1995) found that the rate following ECT did not exceed the rate of cognitive impairment among depressed patients.

Please understand, I do not support uninformed or coerced ECT treatment for even marginally competent people. I also do not (for that matter *could not*) deny that there are people for whom memory and cognitive function after ECT is much, much worse that before ECT.

I simply say that the data doesn't support the idea that ECT kills or damages people any more often than drug treatments or in fact the underlying diseases themselves.

I wholeheartedly agree that ANYONE asked to agree to ANY major medical treatment - especially one that requires anesthesia (as Germ Boy and others indicate, the evidence for risk due to anesthesia is quite clear) - should thoroughly understand the possible risks and benefits. In fact, I strongly urge anyone for whom such a treatment is recommended to seek a second or third opinion before agreeing to be treated.
There is no doubt that the reason for the effectiveness of ECT in relieving depression is unknown. However, the same could be said for opiate analgesics until about 1975. These drugs have been used since before Hippocrates and the dangerous effects (depressed respiration, dependence, coma) were common side effects and complications. They were used without understanding the biological basis for their effects for over 4000 years for only one reason. People didn't have any better means of relieving pain. So they ate the poppy and accepted the risks.

The same is true for the treatment of depression. In spite of the hype from the pharmaceutical industry we do not, in fact, know why people get depressed or how to fix it. All we know is that every so often, we stumble on some drugs or treatments like ECT relieve depression more times than they don't. That's not very comforting for anyone - especially the patients - but that is the way things stand.

Germboy quotes Barb:

>>quote: A couple of months ago a friend of my adult son phoned to say his grandmother was in a psychiatric hospital. My son told his friend "I met your grandma...shes' a nice lady..if they are going to give her shock treatments, do the kind, the merciful thing...get a 45 and blow her brains out.<<

and Germboy writes:

"Please, don't tell me this is resonable response in your eyes. If so then your willingness to polarize your opinion makes discussion difficult."

Germ, why is this not a reasonable response? These are words from the heart of a child who has seen what ECT did to his mother. Would it be better to censor a child's feelings and pretend they do not exist?

Is this how your clinic works, telling people to not express their honest feelings because it's not 'reasonable discussion?'

I cannot speak for anyone else, but I know how I feel about ECT. I was raped a few years ago in a violent manner.

The honest truth is that I would rather be raped again as opposed to more ECT, as hideous as the rape was to me.

Maybe that's not reasonable either, but it's also from the heart.

llama:

>>>I was particularly interested in the argument by several people that ECT has a very high death and injury rate. Since my last intensive look at the ECT literature was about 5 years ago, I decided to check the recent publications.
What I noticed was that almost all of the published material on the damage
attributed to ECS was anecdotal literature -- that is, case reports.<<<

You need to read the original stats from Texas, not studies in journals. Richard Abrams is not about to report in one of the journals on Texas statistics that show such a high death rate.

In fact, I tell people to turn to the statistics kept by the state departments of mental health if they're looking for serious data. When you delve into so many of the journal studies, you'll find that the population studied was 8 people or a similar ridiculous amount.

It just blows my mind that the APA and other lobbying groups work so hard to keep the other 45 states from gathering any stats on ECT. Actually, I guess it doesn't, because the stats really tell the story. There's no Max Fink making up numbers that are carried into national reports. (He has admitted that his 1 in 200 stat concerning memory loss was a figment of his imagination, yet this statistic is continually quoted as an official number.) You get raw data, and it's worth delving into. For example, the California stats show a number forty times higher than Max's "official" 1 in 200 number from his head.


llama:

>>>The most thorough study that I found of the effects of ECT on brain structure
(Devanand, DP et al, Am. J. Psychiatry 151:957, 1994) concluded that they observed no evidence of ECT-induced brain damage in the sample of patients they examined.<<<

This study was a massive review of the literature, not the authors actually looking at autopsied brains or scans. There are studies that dispute this, and say the opposite.

While I am not criticizing the idea of a meta study, I personally think that a group of psychiatrists reviewing the literature is hardly the final word. Psychiatrists simply do not have the same understanding of the brain that neurologists have. They don't have an understanding of how memory works that a neurobiologist might have. They have a better understanding of how medications affect patients, and how many cool purple Zyprexa coffee cups you can fit on a desk, but honestly, their training in brain pathology is not in the same league. (This is not an attempt to smear psychiatry, just an acknowledgement of what most MDs accept as fact.)

Neurologists who specialize in brain pathology tend to be more outspoken about ECT. They are the ones who deal daily in brain traumas. The late Sydney Samant said it most eloquently:

Sydney Samant, M.D., Clinical Psychiatry News, March 1983:

(Copyrighted quote removed - Jill)

A study similar to the one you quoted also reviewed the available literature and came to a different conclusion:

(Donald I. Templer and David M. Veleber
Clinical Neuropsychology (1982) 4(2): 62-66)

(copyrighted info. removed - Jill)

I would also recommend reading the work of Dr. Peter Sterling, a neurobiologist at the University of Pennsylvania School of Medicine. His stuff is just too massive to quote here, but he is adamant that ECT not only causes permanent and extensive memory loss more often than is reported, he remains convinced that it does cause trauma to the brain. Additionally, he has studied the complexities of memory studies, and how little ECT researchers actually know about memory. (He isn't the first to point this out.)

llama:

>>>There is also evidence that pre-ECT cognitive state is a strong predictor of
post-ECT retrograde amnesia (Sobin, C et al., Am. J. Psychiatry 152:995,
1995). That is, some (certainly not all) of the severe memory problems after
ECT may be due as much to underlying organic brain disease as to the ECT
itself. As far as other, non-memory-based cognitive effects, Calev et al (Calev,
A et al., Br. J. Clin. Psychology 34:505, 1995) found that the rate following ECT
did not exceed the rate of cognitive impairment among depressed patients.<<<

I haven't read this study, and will definitely read it. However, I find it interesting that this is a common claim, that the underlying disease is responsible for the memory loss, not the ECT. Why is it then, that so many people remember names, places and events up to the point of ECT, yet after completing the series, huge chunks of time are erased?

Mighty odd coincidences. (And reread the quote from Templer above; it addresses this)

In my case, I could remember a phone number I dialed once for years to come before ECT. My memory was never a problem. After ECT, two years are completely gone, as if they never existed. Those who know me know this story well - I had two friends who died in a tragic plane disaster.

I now have absolutely no memory of having ever known them, despite visits with their orphaned child, visits to their grave on Long Island, despite pouring over photo albums of past good times.

In my mind they do not exist.

If that's not one of the results of ECT, I'll break into a Riverdance and eat my hat.

>>>Please understand, I do not support uninformed or coerced ECT treatment for
even marginally competent people.<<<

But what would your version of informed consent say? That ECT has very small risk of slight, temporary memory loss? Or that there's a decent chance you could lose a chunk of your life....for FOUR WEEKS OF RELIEF.

And the California stats show that the rate (in Cali) of ECT performed FORCED ECT (not coerced, but forced, against one's will) is three percent. That sounds so small, doesn't it? But imagine California stats are reflective of national stats (which I do not believe they are on this issue; California has traditionally had more stringent regulations than the other states).

Annual estimates (imagine a system that cannot provide real numbers because there is no federal mandated reporting!) run between 100,000 to 200,000 people having ECT in the US each year. If three percent of those are against their will, that's 3,000 to 6,000 people every year being forced into ECT. My guess is the number is higher...and this doesn't even reflect the numbers who are coerced, as I was, but gave their consent under threats.




[Note: This message has been edited by JillGat]

GermBoy
Least you are concerned that my friends' Granny had her brains blown out by a 45, rest assured, she didnt have ECT, last I heard, nor was she shot in the head by a bullet.
I spoke with a realtive of this elderly woman on the phone and told him that should ECT be pushed against the grandmother's will, to contact me immediately as I had a contact for help through the agency that had successfully prevented court ordered ECT in 3 elderly women in the past few years in this state. All three elderly women were being taken to court to have ECT against their will, and of course, it was to "save" their lives. All three were still alive last I heard.

This past week I spoke to 2 professional writers ( who are working and not deisabled by ECT) and asked their opinions of using the statement made by my son in my writings on ECT, and both assured me that the statement would be interpreted as an indication that the devatating effects of shock were worse than death. On this I certainly agree. I have asked several shock surviovrs recently re that statement, and was told "that's for sure" ..and "that is true".

No, I don't feel it is a reasonable thing to do to blow the brains out of an elderly woman with a 45, but I also do not believe it is resonable to damage their brains with up to 150 volts (or more)..yes, I said *volts* of electricity sent numerous times through both sides of their brains.

Over the last 15 years I've spoken to likely 200 shock survivors, and numerous realtives of persons who have had ECT (including persons whose relatives suicided after stating that the effects of the ECT or the "treatment" or "therapy" had driven them to suicide) Persons who have had "enough" shock...enough to disable them, rob them of years of precious memories, their professions, their family ties, their talents, and have been left fumbling about all day, every day, looking for things, writing notes to themselves on their hands (and then forgetting they wrote the notes)...etc.......tend to view that statement from a different light, especially a different light than those who have promoted and or adminitered this treatment.

Within the last 3 or 4 hours I happened to see a TV show...a couple from Chicago had accompanied a group of young people to Poland, visiting the sties of former camps for the Jews. The woman stated examples of people who "blew their brains out"...rather than face what was ahead. The reactions of the large group of young people were not "That was not reasonable/rational" etc etc. Of course, I doubt any of those young people were health care providers or professions, so perhaps they did not see the statement in the proper perspective.

Thank you Juli for attempting to clarify what I stated in that post. You do not need to explain to me that you feel being violently raped is something you would want again for yourself or anyone else. I understand what you are attempting to convey. (Least it be interprested that you are reccomending rape as an alternative to ECT!)

I have spoken at length, in the past, to a woman who was raped by 2 men at knifepoint. She had ECT a year later. She too stated that the effects of the ECT were far more traumatic than the rape, and if she no choice but to have a "repeat" of one the two, she'd pick the rape by knife point.

ECT rapes the mind, body and spirit...the very core, the soul of the person. It is a violation, and often a mutilation, of what God created, in the truest sense of the word.

Barb & Juli,
Thanks for your postings, sharing your experiences, and clarification of Granni-cide . That ECT is implicated in your pain causes me to re-think some things. I've never had a vested interest in ECT as a treatment and would not choose it for myself. I cannot dismiss the people who have benefitted by it any more than I can dismiss your painful experiences.
And one last clarification:I would not ever censor a child's feeling to suit my comfort.My remarks concerned the act of killing another person. I understand your point. Chilling, nonetheless.

LLAMA

There you go again.... THE DATA DOES SUPPORT THE FACT THAT ECT KILLS. KILLS AT SUCH A FREQUENCY AS TO INVALIDATE IT AS A VIABLE TREATMENT... I REFER YOU ONCE MORE TO THE LATEST BENBOW STUDY. YOU PEOPLE (SHOCK SUPPORTERS) SUFFER FROM SELECTIVE BLINDNESS WHEN REVIEWING THE LITERATURE.

Of course I and others on this board have the dubious ''advantage'' of KNOWING just how it wrecks lives. If we can arrange it, will you have 10 ''treatments'' to prove your faith in the process?

Incidently, I hope you have now sorted your own ''confused'' state of mind and reassured yourself that that the figures I gave previously are in fact correct...? That 25% of shrinks in that survey had wittnessed shock kill or cause serious medical consequences?

Pat
As a shock survivor, former teacher and RN who is disabled by the verified damage that ECT did to my brain during out pt ECT in 1983, I can tell you that "informed consent" for ECT doesn't exist (by law) except for the state of Texas. Texas requires that persons undergoing ECT be informed of the possiblity of permanent memory loss and brain damage, development of spontaneous seizures (i.e epilepsy). The consent is required before each treatment.
I've spoken with likely over 200 shock sruvivors over the last 15 years, and whether they had ECT in the 50's, 60's, 70's, 80's or 90's, none were informed of the possibility or more accurately the probability, of permanent memory loss and cognitive impairments and on going daily short term memory problems they could/or likely would acquire during their "therapy."
Though Cecil Adams article/answer of March 19 seemed to convey that the intent of ECT in its early days was the production of a seizure, early shock experts were quite open in stating that the "aim" of ECT was to produce brain damage.
In 1941 prominent US psychiatrist Walter Freeman stated:
"All of the above-mentioned methods (i.e. various forms of shock and drug treatments are damaging to the brain, but for the most part, the damage is either slight or temporary. The apparanet paradox develops, however, that the greater the damamge, the more likely the remission of psychotic symptoms...It has been said that if we don't think correctly, it is because we haven't "brains enough." Maybe it will be shown that a mentally ill patient can think more clearly and more consturctively with less brain in actual operation."
In 1948 US psychiatrist Paul Hock stated "This brings us for a mement to a discussion of the brain damage produced by electroshock...Is a certain amount of brain damage not necessary in this type of treatment? Frontal lobotomy indicates that improvement takes place by a definite damage of certain parts of the brain."
When shock treatment was introduced (1938) and during its first big era of popularity (the 1940's) many prominant psychiatrists openly admitted it "worked" by damaging the brain. Euphoria is a known side effect of some types of brain injury.
Nor is the idea that a grand mal seizure is somehow the goal or the method of lifting depression. In the 1990's shock doctor authorities are open about stating that current administered is suprthreshold, generally two and half to 3 times the amount needed to induce a grand mal seizure.
My records show between 120 and 150 *volts* of current applied to both sides of my brain.
Some persons say that now shock is "all different"...it isn't like it used to be." By that they mean not like Jack in One Flew Over... By the mid to late 1950's muscle relaxants ( anectane, a form of curarae) and short acting general anesthetics (like Brevitol) were already being widely used, and were pretty "standard" by the 1960's.
This made ECT less unpleasant to watch. It it no way changed the amount of damage being done to the brain by the electricity passing through the frontal and temporal lobes. For some reason, it seems "OK" if they do this to the patient when they are "asleep"...as if the "worst part" was the treatment itself. Traumatic as ECT was without general anesthetic, I assure you, the procedure itself was not as truamatic as the resultant , generally permanent memory and cognitive impairments the person is faced with often for the rest of his life.

Barb wrote:

>>>This made ECT less unpleasant to watch. It it no way changed the amount of damage being done to the brain by the electricity passing through the frontal and temporal lobes. For some reason, it seems "OK" if they do this
to the patient when they are "asleep"...as if the "worst part" was the treatment itself. Traumatic as ECT was without general anesthetic, I assure you, the procedure itself was not as truamatic as the resultant , generally permanent memory and cognitive impairments the person is faced with often for the rest of his life.<<<

One of the things that aggravates me greatly is the fact that when arguing that ECT is safe, people start pulling out quotes from publicity brochures.

"Today's ECT isn't like the ECT of Cuckoo's Nest."

"They use less electricity."

"It's very precise"

The problem is that those brochures and films (which are the very aids used in providing "informed" consent) contain blatant lies. They've been repeated for so many years that now these lies are fact and nobody bothers to check original data to confirm anything.

Barb, you're absolutely right...today's ECT is kinder and gentler ONLY because it's sanitized for viewing. It's a lot easier to watch a patient's toes wiggle than a patient who is flopping around on a table breaking bones.

Many people seem to believe that means that very little is going on within the body because only a toe is wiggling. That body would still be flippping around, but is paralyzed. The effects on the brain are no different.

And this crock about less electricity? In the olden days they used perhaps one-tenth of a second of juice.

Today, the average is two full seconds. And Richard Abrams recommends five seconds in many cases. But of course that's not in the brochure...that's only in the book that is intended only for ECT practitioners.

And believe me, shock docs just out and out lie about it when pressed...Charles Kellner, one of the leading shock docs, was caught on tape in this very lie. (see the Hall of Shame at www.ect.org) He said it's not true that today's ECT uses 1-2 seconds!!!

Another thing that dismays me is the increasing pressure to use ECT. It's driven by money, and psychiatrists are truly feeling the effects of managed care. Incomes are being cut, and they are scrambling for ways to maintain the lifestyles they have.

Psychiatric Times recommended one way to boost income was take a week-long course in ECT and add that to your practice. They said that a doctor could double his income.

If that doesn't lead to $$$-driven ECT, I don't know what does.

To Cecil, Llama Boy, all you out there who seem to be enarmoured of ECT.It has taken me days to print out and read your posts. It takes me that long to read anything since ECT. ABithell was right, the bits you want to pick up on are only the ones that suit your arguments. Well unfortunately, I don't have that choice. These days I can't quote figures and details, all I can do is tell you what I am like since ECT.

I gave my consent, believed what the Doctor told me. Almost word for word the same as you often quote. The usual LIES that we are told, about, no damage, no lasting side effects. Happy Days will be here again.

Well let me tell you, it sure does do damage and the effect are permenant.

I had my sessions of ECT in 1994 - 95.
I had been a taxi driver for more than 20 years, knew the city like the back of my hand, after the third, fourth, fifth session. I can't remember which now, anyway I was driving to an appointment and all of a sudden I knew where I was and where I wanted to be, but not how to get there. From there it my life went down hill like a rocket.
I had been an independant, working woman, who in my spare time wrote poetry, short tories, read books. enjoyed a full social life.

Now I have the cognative ability of a six year old. This is verified by medical tests done since 1995. I can't read properly, I can only write using a computer because I can't hold a pen any more. Also it can correct my many spelling mistakes. I can start to write a word or a sentence and forget what I was going to write. I have to have a Guardian to manage my bank account because I look at figures and they mean nothing to me. Not even to do simple adding up.

Last month the gas boiler went out. I lit a match and stuck my hand with the match in it it inside the boiler to try to relight it.. Even my 9 year old Grandson would have had the ability to know that was dangerous. I didn't, it nearly took the ends of my fingers off.

I can't cook, I forget I have pans on the stove or food in the oven. Only last week I went to do some toast, forgot I'd lit the gas. Sometime later when my carer checked in on me the downstairs was thick with black smoke. If he hadn't come I could have burnt myself to death.

I've crashed my computer more times than I've had hot dinners because I forget which is the right button or instruction to click.

I can't fill forms in, the questions confuse me if I have to write an answer instead of tick a yes or no.

Am I boring you yet?

Do you know the worst part? I am intelligent I understand exactly what has and is happening to me. Can you even imagin the frustration this causes. When I want to do something that before ECT I would have done automatically. Now I can't remember what to do, never mind how to it.

I can't tell left from right, it takes me minutes to work out that I write with my right hand, so that way or side must be right.

You carry on quoting your facts and figures, but think on this...

Never mind how many people like Barb and ABithell and all the many other people who try to convince you ECT is BAD. If we deter one person from having ECT we will have helped someone not to end up as we are. What about the many you help to decide to "risk" it. Through your inabillity to see what's hitting you the face, you could be condeming someone to end up as I am. ECT is not a therapy or a help. It is a thing which belongs in the age of the Inquisition, It's barbaric and as a friend of mine says "A rape of the soul." Don't any of you have a concience.

It's all well and good advocating something you've not even tried... not risked.

I don't know how long it's taken you to read my post or even if your still reading it, but if you are, it might interest you to know it's taken me over five hours to put these words together and write.

I personally will never give up the fight to see ECT abolished. I didn't learn about ECT and it's effects from books, surveys or quotes. My knowledge comes from living with the damage of ECT.
I hope you never have to live this way. Although I sometimes think you deserve to when I read the rubbish you write about a subject you've only read about or even helped administer.

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Some years back I read that people who had had head trauma (such as from an auto accident) had a higher incidence of Alzheimer's disease. Someone made a connection to ECT and wondered if people who had brain damage from ECT were also more likely to get Alzheimer's disease. I wonder about this because my mother, who had ECT, developed A's disease twenty years later, and died from it about ten after that.The onset of A's disease is so gradual, you can't really tell when someone starts to get it. Does anyone know any research about this?

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Pat Stoll

My mother had ECT in the early 60's. I knew she was going to a mental institution but I thought they would be talking to her, you know, psychotherapy. Found out only later they gave her I-don't-know-how-many ECTs. When she got back home, she didn't know me. She had to re-learn everything, including how to cook. I wasn't very sympathetic, I'm afraid. She had been a difficult person before ECT, and I still had some resentments. She wasn't any less difficult afterwards, just more wary. "I'd better behave or they'll do that to me!" Now that I know more about ECT, I am horrified about what they did to her. Talk about informed consent: nobody, even my father and brother who signed for treatment, were "informed" about what ECT could really do.

As with Chris, this is now my 4th or 5th try at writing an answer to a post, and I began this task 4 and half hours ago...each time, trying to "get to the point" and then trying again and again because I get off the track. This is my last shot, on this one.

Juli

Holy Moses! You mean this is *for real* a one *week* course on ECT? I'm really impressed!!! And here I thought that the standards for ECT were the same as years ago!
Who says that efforts aren't being made to improve "standards"?????

I have before me here a flyer from 1991 for a one *day* certificate course in ECT.

"This how-to-do-it course teaches the skills for giving ECT accoring to the APA's new "Reccomendations for Treatment, Training and Privileging."
"Following didactic sessions in the morning and early afternoon....including a 45 minute Q&A period with a panel of course faculty..course attendees assemble into small preceptor-led afternoon groups for hands on demonstration of a reccomended treatment sequence, using patient mannequins and the latest ECT devices."

Yes, they practice on a mannequin, take the test and golly gee...since Abrams flyer on his Thymatron states "ECT WITHOUT MEMORY LOSS" and since it is just so safe, howz come the docs just don't use themselves for the "practicum" and "hands on demonstration" (Oops...there I go again, now just *why* would the psychiatrists do this to themselves? They assuredly aren't mentally ill...sorry, ...I *forgot*...)

Flyer continues:
"Upon completing the course and passing a written examiniation, each registrant will receive a certificate documenting that he has completed the course and demonstrated knowledge of the use and procedures of electroconvulsive therapyy. In addition, all attendees earn 9 hours of category 1 CME credit."

I wondered about that ..the 9 hours of CME credit, and finally figured out, if they count an hour of CME credit for each hour of the "The Technique of ECT", then seems they are giving them CME credit for the half hour coffee and pastry buffet, the 45 minute sit down (yes, sit down) luncheon and the half hour of "refreshments" in the afternoon. Fantastic way to earn CME credit..by eating .
Course was offered by none other than....Dr Richard Abrams, who holds the patent on, manufactures and sells direct the Thymatron, that wondrous machine where the doctor simply sets the dial to the patinet'ss *age* and it automatically delivers the right ammount of current (Amazing , huh,??) Abrams was also (for years) an expert witness coming against persons trying to sue for ECT damages,

I had many other comments Juli, to your last post, and decided it best to not make this post 10,000 words.I spent the previous 5 hours going over and over and trying to "get to the point"...this is my "best shot"...

Theres' a bumper sticker that says "Of all the things I ever lost, I miss my mind the most." To that I say there is a distict difference between losing something, and having it taken.

Pat
From what I know about A's Disease, they used to say the only way to truly diagnose it was on autopsy, when they found tangling substances in the brain.
RE the relationship between Alzsheimers and head injury I've certainly heard.

I was diagnosed as "dementia" "Organic Brain Syndrome" at age 41, less than a year after I had 13 out pt ECT. Less than a year prior to the ECT I had graduated with honors as an RN at age 40.

You may want to read "ECT As A Head Injury" at www.ect.org. You will also find much info, at http://members.aol.com/wmacdo4301

We tend to think of someone with Alzheimers as being confused, getting lost, starting fires when trying to cook, not recognizing people they'd known well for many years, and not knowning how to perform simple tasks that they prior could do without thinking, being overly emotional, easily upset when they cant remember things etc, and seeming to have a "very good memory" of things that happened long long ago but sparse memory of mroe recent events in time. All these symptoms are indicative of damage to the brain, particularly the frontal and temporal lobes. All these symptoms I experienced and continue to experience, due to ECT. Same goes for many many shock survivors.
With ECT persons are told "it will all come back...in a few weeks...in a few months...(though they were first told it wouldnt happen at all)...and when it doesnt come back, they are told these are simply symtpoms of depression.
Your mother did learn what could happen if she made too many "waves"...so do most shock survivors, as far as going back and trying to tell the doctors about their damages due to shock.

Is the damage from ECT progressive? Yes, in many cases it is...it gets worse as time goes on. This also happens with certain head injuries. The stress of attempting to "operate" on an impaired brain takes it's toll.

Doctors arent likely to acknowledge anytime soon that ECT leads to "Alzsheimers".

A few months ago when a friend was hospitalized with bleeding into the brain (a stroke) a doctor came into the room and asked if she had ever had seizrues. Later I told the doctor "She had ECT years ago" and he said "That wasnt what he meant". I responded.."Oh, if a doctor gives them (seizures) to you, then it doesnt count?" He had no response, but a rather quizacle look on his face. I didnt push it further by saying that the bleeding into the brain happend to be at the exact location of placement of one of the electrodes in ECT, because, I'm sure that was puerly "co-incidental".
The seizures given with ECT are not the same as a spontaneuous grand mal seizure. Even in the 1990's docotors acknowledge they use commonly, 2 and half to 3 times the amt of current needed to invoke a grandmal. If the sizure were the "goal" of the "therapy" this would not be necessary.
I had a fracture of a thorasic vertebra and athe jaw during my "new and improved" ECT in 1983. I know a woman who had such a fracture with shock in the 90's and a man who had a vertebral fracture in the 1980's. During the 1940's such fractures were common...not maybe 1% as the original article quoted...more like 20 to 40%.

How many people have you heard of who fractuered a vertebra during a spontaneous grand mal seizure? Then why would it happen during ECT?

ECT is an electrically induced brain injury. Some persons have less damage, but generally, (not always) the less ECT one has, the less damage one has. "Bilateral" seems to cause more damage than "Unilateral"..and that seems understandable to me.

The old shock certainly wasnt less damaging than the new shock, or vice versa.

When God said "Let there be light", I sincerely doubt he meant 150 volts through both sides of the brain.

Believe it or not, this is a fact, ECT is prescribed for the depression of A'ls Disease, and for persons who are depressed following a stroke and or traumatic brain injury from car accidents etc.

Chris' post describes not just an "occasional bad day"...but rather how it is all day, every day for those of us attempting to live with the effects of ECT. For me, it is now nearly 16 years.

Barb wrote:

>>>I have before me here a flyer from 1991 for a one *day* certificate course in ECT.
"This how-to-do-it course teaches the skills for giving ECT accoring to the APA's new "Reccomendations for Treatment, Training and Privileging." "Following didactic sessions in the morning and early afternoon....including a
45 minute Q&A period with a panel of course faculty..course attendees assemble into small preceptor-led afternoon groups for hands on
demonstration of a reccomended treatment sequence, using patient mannequins and the latest ECT devices."<<<

Good lord. The sad thing is that patients don't have a clue that the majority of docs are out performing ECT after a day's review plus donuts.

I'm sure that had Psych Times had the brochure in front of them while writing that article, they would have promoted it: Take a one-day course, DOUBLE YOUR INCOME. Includes donuts!!!

The whole article was written for psychiatrists who are facing financial hard times due to managed care. I don't begrudge anyone trying to make a living, whether it's 20,000 a year or 2 million a year. I *do* condemn learning a "technique" for no other reason than to double your income. Financial pressure leads to these doctors pushing for something that is going to make them money.

They'll talk all nice nice about how you need ECT, how it will help your depression and all that nasty stuff you heard about it is lies. The bottom line for them is $$$. There's money to be made in ECT, from every side.

Even Abrams promotes his Thymatron every chance he gets. In his book (Electroconvulsive Therapy, Oxford University Press), considered the bible for shock docs, he very cleverly promotes it over other shock machines by continually talking about features that you need. Of course the Thymatron is the only machine with these great features.

His journal articles do the same, although sometimes he actually mentions the Thymatron by name. Never do the journals mention that he owns the company.

What other field in medicine tolerates this? If the world's leading infectious disease specialist continually promoted Zithromax as the one antibiotic over any others, wouldn't collegues become a little suspicious when it turned out he owned Pfizer?

To my knowledge, the only time it's ever come up was when a journal article promoted Somatics' (Abrams' company) mouth guard, which was horribly expensive. A doctor wrote in to say you could use a sports mouth guard from a sports store for much cheaper. Of course Abrams hit the roof.

ECT is his gravy train, and IMO, it's the gravy train of the future for psychiatrists. Insurance and Medicare pay 100 percent.

It's going to be revolting to watch the ECT rates go up over the years, but it's going to happen.


----- Juli

To Llamafresh --- with reference to your statement about the Devanand Report about ECT and brain structure, I too have that Report. It is called "Does ECT Alter Brain Structure" and it a review of the literature not a sample of clients. Also, there were six authors of that report; one of whom "Harold A. Sackeim" has admitted publicly in the Washington Post (September 1996) that his research is partly funded by the shock-machine companies MECTA and Somatics. Below are a list of papers that state that it does do harm to the brain and does cause death. It all depends on who is doing the research -- doctors who have a financial interest in ECT usually find that it is safe and effective while those without a financial interest usually find that it dangerous, it depends on who you want to believe. Anyway, here is the list:

BRAIN DAMAGE:
Marcheselli, et al 'Sustained induction of prostaglandin endoperoxidase synthase-2 by seizures in hippocampus' J Biol Chem 1996; 271: pages 24794-24799
This study showed that ECT causes an increase in the production of inflammatory proteins in brain cells.Troll

Coffey, et al, 'Brain Anatomic Effects of ECT' Arch Gen Psych 1991; 48: pages 1013-1021
This study, conducted at Durham VA Hospital and Duke University Medical Center, looked at the MRI brain scans of 35 patients before and after receiving ECT. The study, conducted by C. Edward Coffey MD (a leading advocate of ECT), showed that 8 of the 35 patients (22%) were showing NEW brain changes after receiving ECT. One of those showing the brain changes suffered a stroke and two were showing abnormal neurological signs within six months of receiving ECT.Troll

Andreasen, et al 'MRI of the Brain in Schizophrenia' Arch Gen Psych 1990; 47: pages 35-41
Andreasen used MRI scans to demonstrate a strong correlation between the number of previous ECT treatments to enlarged ventricles (loss of brain tissue).Troll

Figiel, Coffey, et al 'Brain MRI findings in ECT-induced delirium' J of Neuropsych and Clin Sci 1990; 2: pages 53-58
ECT-enthusiast Dr. Coffey and his associate Dr. Figiel found that 10 out of 87 (that's 11% of) elderly patients getting ECT for depression remained delirious between ECT sessions for no discernible medical reason other than the ECT itself. The scans showed that 90% of these patients had lesions in the basal ganglia areas of the brain, and 90% also had white matter lesions.Troll

Dolan, RJ, et al 'The cerebral appearance in depressed subjects' Psychol Med 1986; 16: pages 775-779
An English study which compared the brain CT scans of 101 depressed patients who had received ECT with the scans of 52 normal volunteers. The study found a significant relationship between ECT treatment and brain atrophy -- ECT patients were twice as likely to have a measurable loss of brain tissue at the front and three times as likely to have a loss of brain tissue at the back of the brain. The study also showed that the brain abnormalities correlated only with ECT, and not with age, gender, severity of illness, previous history, etc.Troll

Calloway, et al, 'ECT and cerebral atrophy: a CT study' Acta Psych Scand 1981; 64: pages 442-445
A CT brain scan study which showed that frontal lobe atrophy (brain shrinkage) was significantly more common in those who had received ECT.Troll

Weinberger, et al, 'Structural abnormalities in the cerebral cortex of chronic schizophrenic patients' Arch Gen Psych 1979; 36: pages 935-939
Weinberger looked at the effects of ECT on the brains of schizophrenics by comparing brain CT scans of those who had ECT with schizophrenics who never received shock. He documented that cerebral atrophy (brain shrinkage) was significantly more common in those who had been shocked.Troll

Cotman, et al 'Electroshock effects on brain protein synthesis' Science 1971; 178: pages 454-456
This report showed that ECT disrupts (protective) protein production by brain cells.

DEATH:
Don Gilbert, Commissioner, Texas Department of Mental Health and Mental Retardation, 1996
Recording of ECT deaths within 14 days of receiving ECT is mandatory in the state of Texas. 21 deaths were reported in the first 3 years of mandatory recording: 11 from heart attacks and strokes, six suicides, and 3 from respiratory problems. Troll

O'Leary, D.A. & Lee, A.S., 'Seven Year Prognosis in Depression: Mortality and Readmission Risk in the Nottingham ECT Cohort' British Journal of Psychiatry 1996; 169: pages 423-429
This British study recorded the mortality and readmission rates of 118 ECT patients over a period of seven years. The results showed that the mortality rate amongst ECT was between two and four times the normal mortality rate, depending on age group. The report concluded that ECT patients had a higher long-term mortality rate and the readmission risk was also increased.Troll

1993 Kroessler and Fogel, 'Electroconvulsive Therapy for Major Depression in the Old' Am J of Geriatric Psychiatry 1993; 1:1: pages 30-37
The survival rate of 65 elderly depressed patients was monitored by researchers at Brown University. The survival rates of those who had received ECT were 73%, 54.1% and 51.4% after 1, 2 and 3 years respectively. By contrast, the survival rates among depressed patients who had not received ECT were 96.4%, 90.5% and 75% after 1, 2 and 3 years. Troll

1984 Babigian, H., et al 'Epidemiologic Considerations in ECT' Arch Gen Psych 1984; 41: pages 246-253
This large retrospective study (3,288 patients) showed that ECT patients had an increased death rate from all causes.
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There are many more studies but I hope this at least proves that it is not just the patients who have found that ECT does harm. A lot of doctors have found the same thing.

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Willi