Federal regulators are poised to enact new restrictions on psychiatry’s most controversial treatment, electroconvulsive therapy, which treats people with acute mental illnesses by sending a seizure-inducing jolt of electricity through their brains.

A draft rule under consideration at the Food and Drug Administration would reclassify ECT as safe and effective — and only moderately risky — for adults with severe depression who haven’t responded to medication or other therapies.

But it would also impose new requirements: Physicians would have to warn patients that the side effects of ECT, also called electroshock therapy, can include confusion and memory loss and that its long-term safety is unproven. They’d have to monitor patients’ memory and cognitive skills before and during treatment with sensitive neuropsychological tests.

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And the FDA would also classify ECT as high risk for psychiatric conditions other than depression and for children and adolescents.

A high risk designation isn’t just a symbolic gesture: Psychiatrists warn, with alarm, that it could prompt insurers to stop covering and doctors to stop recommending ECT for younger patients and for those with conditions such as schizophrenia, mania associated with bipolar disorder, and the stupor-like state known as catatonia.

“Its use for these indications is widespread, even ubiquitous, and to deny the extensive evidence in support of that is indefensible,” said Dr. Charles Kellner, a professor of psychiatry at the Icahn School of Medicine at Mount Sinai in New York City and chief of the ECT service at Mount Sinai Hospital.

Many patients, however, take the opposite view: They say after decades of letting ECT proceed without rigorous evaluation, the FDA should take a much tougher stance. They blame the shock therapy for causing severe cognitive and emotional damage and call for tight restrictions or an outright ban.

Deborah Schwartzkopff, for instance, had 66 ECT treatments between 1996 and 2010 to treat depression. Schwartzkopff, 55, a registered nurse from McMinnville, Ore., said the therapy left such gaping holes in her memory that she couldn’t recall her wedding or the birth of her children. Her marriage of 28 years ended “because I couldn’t remember that relationship, and without those memories, I had no emotional connection,” she said.

“Personally, I think ECT should be banned, but at a minimum, we should be testing these devices for their safety and effectiveness,” Schwartzkopff said.

The FDA received 2,040 comments on its draft rule before the public comment period closed in late March. The agency has not given a timetable for issuing a final rule.

Shock therapy
A detail of an electroconvulsive therapy machine. Kayana Szymczak for STAT

A long way from ‘Cuckoo’s Nest’

About 100,000 patients, most of them with intractable depression, receive ECT in the US each year.

The treatment has come a long way since it was depicted as a barbaric and terrifying tool for subduing patients in “One Flew Over the Cuckoo’s Nest.” Patients get anesthesia to minimize pain and muscle sedatives so they’re less likely to hurt themselves during the seizure. Ultra-brief pulse therapy delivers a fraction of the electricity used in the past. And the electrodes are positioned to minimize side effects.

ECT benefits nearly 80 percent of patients who try it, mostly for the short-term, according to a research summary prepared by the FDA.

Among the many patients who have hailed it as a lifesaver is Kitty Dukakis, the wife of former Massachusetts Governor Michael Dukakis. She has said ECT helped her overcome decades of disabling depression and alcohol and drug addiction.

Precisely why electroshock therapy works is a mystery. Some studies suggest the procedure can stimulate the growth of brain cells and the release of neurotransmitters, activating the brain’s electrical networks. Yet other studies raise the potential for harm, noting for instance that ECT can cause tiny hemorrhages or interfere with connections that underlie the brain’s complex circuitry.

The most common complication is memory loss, for both events around the time of the shocks and for past events in the patient’s life. A 2003 review of multiple studies, published in the BMJ, found that a third of patients who had received ECT reported memory loss that lasted six months or more.

For many patients, however, cognitive issues resolve in a few weeks or months. That’s what happened to Natasha Tracey, who turned to ECT in 2009 after she lost her job at a Seattle software company and became suicidal.

At first, her memory loss was so severe, she said, that she couldn’t even remember how to get to the grocery store. “The street I lived on looked foreign. Things in my apartment — I couldn’t remember how they got there,” said Tracey, 38. “Fortunately, that cleared up and I don’t feel any lasting impact.”

Although ECT didn’t help Tracey, she believes the therapy is an important option for patients who have tried other therapies that haven’t alleviated their suffering.

Shock therapy
A detail of an electroconvulsive therapy machine. Kayana Szymczak for STAT

A chilling effect

The FDA’s move has been a long time coming.

The agency has had the authority to regulate medical devices since 1976, but for decades let ECT machines alone because they’d been in widespread use since the 1950s. In 2009, however, the US Government Accountability Office, a watchdog, said it was time for regulators to evaluate all potentially dangerous medical devices, even those that had been around for years.

That meant the FDA had to make a choice: Regulators could classify ECT as high risk and require ECT manufacturers to conduct clinical trials proving that their machines were safe and effective. (Trials are required for all medical devices newly designated high risk.) Or they could deem the machines only moderate risky, based on the weight of existing evidence from scientific studies.

After contentious hearings, a FDA advisory panel in 2011 recommended that ECT devices be designated high risk for all patients.

That recommendation touched off a storm of controversy. And the FDA effectively tabled the issue, declining to move on it — until now.

In its new draft rule, the agency says it accepts existing evidence of ECT’s efficacy for adults with severe depression and proposes that devices be put in the “moderate risk” category for this group of patients.

“All of us sighed a big sigh of relief,” said Dr. Stephen Seiner, director of the psychiatric neurotherapeutics program at McLean Hospital in Belmont, Mass., which performed 10,000 ECT treatments last year — the most in the US. “It’s an important message to the medical community that ECT is safe.”

But the FDA notes it isn’t similarly convinced by the evidence of ECT’s value for patients under 18 and for those with other psychiatric illnesses. If its proposed rule stands, the agency will require manufacturers of ECT machines to launch clinical trials for these indications. It’s widely expected they will decline to do so because of the cost.

In that event, physicians would still be able to provide ECT “off label” to patients with mania, schizophrenia, catatonia, or other conditions. But insurance companies may refuse to pay. And physicians may worry about the potential for malpractice lawsuits if anything goes wrong.

Labeling ECT “high risk” for conditions other than depression will have a “chilling effect” on the therapy for thousands of terribly ill patients, most of whom have exhausted all other options, said Dr. William McDonald, a professor of psychiatry at Emory University.

Both the American Psychiatric Association and the National Alliance of Mental Illness, a leading consumer group, take issue with the FDA and say the agency should classify ECT as moderately risky for all conditions for which it is commonly used.

Shock therapy
A treatment room in the Electroconvulsive Therapy Clinic at McLean Hospital in Belmont, Mass. Kayana Szymczak for STAT

Preventing relapse

Relapse is common with ECT, and many psychiatrists recommend monthly “maintenance” sessions after an initial round of therapy — usually nine to 12 treatments over the course of three to four weeks.

But the FDA’s proposed rule doesn’t recognize maintenance ECT as of proven value or designate it moderate risk. Psychiatrists also want to change that.

Kate MacDonald, 70, of Cambridge, Mass., had maintenance therapy for over a year after she received ECT treatment for severe depression at McLean in September of 2010. Before the treatment, she had lost 40 pounds in five months and was becoming unresponsive and paranoid, she said.

After only a few treatments, she began to respond: “I could carry on a conversation again. I had some light in my eyes.”

She’s convinced ECT saved her life.

“The memories I’ve lost are almost all related to the time I was sick,” said MacDonald, who volunteers for three organizations and says she’s as happy as she’s ever been. “If someone said to me, ‘Kate, you’re [either] going to lose a whole bunch of memories or be depressed the way I was,’” she said, “I would say, ‘Take the memories.’”

Correction: A previous version of this story misspelled Kate MacDonald’s name.

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  • RE: Deirdre Oliver
    This person says that people who disagree with her don’t know “WTF” they’re talking about. Personal experience gives me the expertise to know what I am talking about. If you have ever been so depressed that you put yourself in a coma be ODing. And ECT brought you back from that brink, don’t say I don’t know “WTF” I’m talking about, because I do.

    • Dear Jane,
      Yes, I did say that and here is a list you might like to look at explaining why I said it.
      First: If you have ever worked in a Trauma unit when head injured patients are brought in, it is common for them to say they feel fine, some, with `concussion euphoria’ are more than `fine’. They are anything from mildly happy to euphoric even though they might have no idea where they are, who they are, or what has happened to them.
      Others may be apathetic and very easily persuadable as their critical faculties have been dulled. You might say, `are you happy?’ and they might rely `yes’, then 10 minutes later you ask the same person, `are you sad? and they’ll say yes to that, too, though nothing in their circumstance has changed.
      I’ve sent many years researching this subject and don’t make claims lightly. Chats in the corridor with dazed and brain injured people is not scientific evidence. The list below is. All of it is available online.

      Read, J. & Bentall, R. (2010). The effectiveness of electroconvulsive therapy: A literature review. Epidemiologia e Psichiatria Sociale, 19, 333 ff.
      Ross, C. (2006). The sham ECT literature: Implications for consent to ECT. Ethical Human Psychology and Psychiatry, 8, 17-28.
      Sackeim, H., Prudic, J., Fuller, R., Kielp, J., Lavori, P., & Olfson, M. (2007). The cognitive effects of electroconvulsive therapy in community settings. Neuropsychopharmacology, 32, 244-255.
      Zarubenko, I., Yakolev, A., Stepanichev, M., & Gulyaeva, N. (2005). Electroconvulsive shock induces neuron death in the hippocampus: Correlation of neurodegeneration with convulsive activity. Neuroscience and Behavioral Science, 35, 715-721.
      Prudic, J., Olfson, M., Marcus, S., et al., “Effectiveness of Electroconvulsive Therapy in Community Settings,” Biological Psychiatry 2004;55:301-312. (benefit/ raised mood 30-46% people max. 10 days later 40% `improvement rate GONE – ALL will relapse within 6 months.)
      John M. Friedberg, M.D. -American Journal of Psychiatry 134:9, September 1977. Shock Treatment, Brain Damage, and Memory Loss: A Neurological Perspective
      Shock Treatment: Efficacy, Memory Loss, and Brain Damage – Psychiatry’s Don’t Look, Don’t Tell Policy Richard A. Warner Email: windwarner@msn.com
      Protesting ECT: A Moral/Existential Calling By BONNIE BURSTOW, PH.D.
      Featured Blogs Mad in America March 31, 2015
      Also check Peter Breggin & ECT online
      Some of these are against ECT, some are supporters of it.

      PS: I’ve been on life support several times from ODing – From ECT I received brain damage that cost me my career, PTSD, depression and despair, nothing else, so while I respect your experience, kindly don’t imply that I don’t know WTF I’m talking about.
      PPS: Just a little illustration of ECT and its effects – This from 10 people I didn’t know or barely knew who offered me their experiences of ECT. All were acquaintances or family members of ECT recipients- 4 were dead, 3 suicides (directly attributed to ECT) and a cardiac failure 3 months later; 6 had ruined lives and ONE did well. Not good odds, I think.

  • I underwent mainanence ECT in the mid 1990’s and credit it that I am still alive. Did I have memory loss? Yes. But at least I didn’t commit suicide and have been alive to form new memories.

  • From 9/2017 through 1/2018 I had over 40 ECTs three times/week as an outpatient. I ended up I. An in-patient unit because I thought I was becoming suicidal (although in retrospect I just felt I couldn’t tolerate any more treatments). Even as an IP U was given 2 more ECTs without my consent. My daughter demanded my release after 5 days. I don’t remember any of the IP stay, or do I have any memory until early March, 6-7 weeks later. I still have both short and long-term memory loss, as well as other symptoms. The ECT has very negative consequences for me. Have you heard of giving so many treatments? Is this normal or standard? Have you heard of long-term effects from this? My gut tells me this was abuse of treatment and malpractice.

    • I’ve had ECT several times and it’s worked great for me, I’m sorry you’ve had such a negative experience. From what you’ve said, it does sound like malpractice. It’s definitely not standard for anyone to get treatments 3 times a week for more than 4 weeks in a row. Since you said only 2 of them were given without consent, I’m wondering why you didn’t stop (or try to stop) getting treatments long before that? Anyway, they had no right to give you treatments without your consent. That’s illegal unless there is someone who is legally responsible for you that consented for you. But even if someone did consent for you, that is still malpractice for them to give you 3 treatments a week for that many months.

    • You ask why I let the treatments go on so long: The MD kept telling me “You’re having good seizures” (!) and she felt we should continue. I think I felt after so long I was invested and the only course was to go ahead…until I just couldn’t take any more.

  • I thank you for this article (2016) has any further research evidence around ect and the dangers of ECT for patients with mania and other mental illness been published. I am also concerned that a treating psychiatrist who also administered ECT would be considered a conflict of interest. I look forward to your research. Marg

  • Around 10 years ago, I had maybe 30 treatments over the course of a year. At one point my memory got kind of bad (when I was still getting them 3 times a week) but as soon as I started getting them less often, my memory started returning to normal. After about 6 months, I was completely back to normal in every way.
    The treatments worked for me. I was enjoying things that I hadn’t been able to for so long. I was going out and being social, and trying new things. My life was by no means perfect, and I still had bouts of depression at times, but it was nowhere near as bad as it had been.
    Eventually my depression started getting worse again, and I decided to get more treatments towards the end of last year. Over the past 4 months, I’ve probably received around 20 treatments. It seems that this time around the side effects have had even less of an impact. Really, I wouldn’t care even if it did mess with my memory more than it has. I think it’s totally worth it, and I would recommend it to anyone with severe depression.
    Don’t listen to the bs some of these people try to tell you. Doctors are not electrocuting you and giving you traumatic brain injury. I also know I don’t have some impairment that I am unaware of, and I’m sure by now a friend or family member would have noticed. I know there are people claiming ECT gave them brain damage in some way, or that it was completely barbaric, but unless they chose a really unqualified doctor, I call bs. I hate to say it (afterall, I have a mental illness myself) but you have to keep in mind the problems some of these patients have that are getting them done, some have problems with paranoia for example.

    • Dear Mr Leigh – You appear to be one of the 15- 30% of people who feel better following electroshock. That means 70 – 85% don’t. What you don’t take into account is the placebo effect of the treatment which means you got the result you hoped for. This has been established in the few reasonable placebo trials the have been done with ECT. What happened in those was that the people who received the inactive treatment i.e. an anaesthetic but no shock had the same response, or better, as those who actually had the real shock. None of these trial considered the innate placebo effect of the real treatment. If they had, it would have been clear that the `real’ ECT performed far worse than placebo. So was your improvement the result of your expectations, not the action of the electric shocks to your brain that you received? Statistically, highly likely, though `concussion euphoria’ a consequence of acute brain injury and the effect of cutting emotional responses,(to everything) also a result of brain injury, may have contributed to your sense of well-being. I have no objection if you choose permanent brain damage to achieve that sense of well being but I do seriously question whether you should recommend it to others whose outcomes may not be as successful as yours. There is also the issue of whether a doctor whose ethics demand that `first do no harm’ should be offering brain damage as treatment.
      I’m sorry but you can’t say that `doctors are`not electrocuting’ you. They have a machine that delivers up to 450 volts of square wave ELECTRICITY to your head for at least 8 seconds. That electricity causes you to have a seizure and become comatose. The definition of a Traumatic Brain Injury is: the an external force applied to the head that causes disruption to NORMAL BRAIN FUNCTION. Yes, the doctors DID electrocute you and caused you to have a total of 50 Traumatic Brain Injuries. (TBIs)
      Sadly one of the consequences of TBI is that the individual who has it is not necessarily aware of the amount of damage that has been done. The fact that you had memory issues is also a sign that you suffered a TBI. Amnesia is the most common symptom of TBI. Whether or not some of these issues are resolved, at least to your satisfaction. is irrelevant. Every person with TBI can have different consequences. Some are more vulnerable to crippling effects than others. It is reckless of you to recommend a treatment that you are lucky enough to have found useful to people that science has predicted will almost certainly be less fortunate than you. I would be interested to know your job history after ECT, and suggest you have a neuropsychological tests and at least one MRI before you claim you have no residual brain damage. I think you might be surprised.
      I too have had ECT and have been independently diagnosed by neurologists with permanent brain damage. I have received neurological rehab and have managed over many years to once again function relatively normally. However I will never be able to function at the same level as I did before the treatment.
      Electroshock causes brain damage in EVERY case. –

    • Deirdre…first of all it’s M Leigh, not Mr Leigh. It’s too bad so many people are spreading around so much misinformation and disinformation. Most of the people writing these articles or posting comments (such as yourself) aren’t even experts and have no idea wtf they are even saying. There are so many people posing as experts just so they can spread around lies and then have people like you believe them and continue to spread them. You said you’ve had ECT and maybe you have. If what you say happened to you is true, then you must have had a very unqualified doctor.
      It was certainly never the placebo effect for me. I was never expecting it to work in the first place, and both times it took several treatments before I started noticing any changes.
      My doctor gives cognitive function tests every so often before treatments, and you know what? Other than memory, I’m still doing just as great on them as I was before I started getting ECT. I’ll be the first to admit my memory has slipped a little, but I know it’ll be back to normal soon. It’s already been getting much better since I’ve been receiving treatments less often. Trust me, when I tried ECT for the first time around a decade ago, I was really scared that it might cause some kind of permanent damage. I never would have decided to try it again if it had. Like I said before, I’m sure a friend or family member would have noticed it even if I hadn’t.

    • Dear M Leigh, I do apologise for the `Mr’. However it is a bit unfair of you to say that all the people who disagree with you about the damage they have incurred and/or the lack of good outcomes don’t know WTF they are talking about.
      As I said, if you feel you had a good outcome you are one of the few. Statistically, as found in actual studies, even in those done by people with vested interests in finding for ECT, including Harry Sackheim (paid by ECT companies), it was found to `work’ in fewer than 45% of people. That means that for 55% it didn’t. At ALL. That’s for the short period that even the industry claims, whichis a few weeks after the treatment ends,(i.e. while the brain is still acutely injured. The other thing they had to admit because ALL their patients/subjects showed it, was the acute brain injury symptoms that continued for the 6 month follow-up. There have been few if any studies done that followed up past 6 months. That particular study was done in 2007, by people who WANTED to find ECT was effective and safe. They found neither. Other studies once properly evaluated for bias have shown the 15-30% I quoted last time.
      A later study in 2012, found significant brain injury, they called it `changes’ and they used fMRIs to prove it. After that even the leading ECT advocates had to allow that “yes, structural damage (changes) to the brain DOES occur during ECT.” That was followed up by about 6 other studies, all of which I read, and all of which documented physical brain damage. So, M Leigh, I DO know what I’m talking about.
      Now, I don’t know what these cognitive tests you have are but, according to the Brain Foundation, an organisation in the USA that deals with neurological issues, the most common manifestation of both acute and chronic brain injury is disturbances in MEMORY. So If you have memory issues, you have brain injury. Memory disturbances simply do NOT occur in people who have not had any kind of brain injury. That may be from trauma or disease.
      Traumatic brain Injury (TBI) occurs when an external force to the head causes a disturbance in normal brain function.
      ECT is an electrical force to the head of up to 450 volts of square wave electrical pulses for at least 8 seconds. This causes a seizure and a coma. Both of these are serious disturbances of normal brain function.
      Therefore ECT causes a Traumatic Brain Injury. That is simple logic.
      There is little information about accidental electrical injury to the head as it is rare but its outcomes are the same as other TBIs.
      The neurological outcomes are well established and you can look them up on line. Please understand that I am very well informed in both ECT and neurology, and am not `posing’ as an expert.
      Also, if you go to the Harvard website and look up `placebo’ studies you’ll get a better idea of how it works. It isn’t as simple as `expectation’ of something working, it’s more associated with `hope’. The more desperate a person is the more they HOPE whatever it is might work, even if they don’t expect it to. The few reasonably designed placebo studies really did show that real ECT didn’t work any better than the placebo, and in many cases it didn’t do as well. Add that to the inherent placebo effect in the real ECT and you realise that all those people got a head injury for little effect.
      I was a psychiatric professional back in the 1970s and we all knew ECT wasn’t much good and caused injury so we were cutting it right back. It was only when the private hospitals started to proliferate in the late 1970s and onwards that it got sanitised and started up big time. You know why? It is extremely lucrative! It covers the bottom line of these places and brings in $MILLIONS every year.
      PS: A recent group action in America successfully sued the ECT manufacturing companies for selling a product that causes brain injury. They had to first establish that people actually GOT brain injuries. They did and won the case. It is the beginning of the end of this brutal `treatment’ that should have gone the way of Insulin Coma treatment and lobotomy 50 years ago.

    • I also read a comment in this column that said no more than 30% of patients receiving ECT are helped by it. I’m sorry, but not only have I read differently, but my own experience in talking to fellow patients does not prove this out. Most of my fellow patients received some, if not significant benefits. She suggest it is the placebo effect. Might I suggest, because it didn’t “cure” the problem, now the treatment if not treaters are being vilified.

  • I use medical marijuana for pain.
    Should I stop using it before beginning ECT therapy? If yes; how long before the start of the ECT should I stop?

    • @Mike Andrews: In the strongest possible terms, I suggest you do **NOT** get “Electro-Cution Torture”. (“ECT”) Read ALL the comments here, then spend a couple hours at >madinamerica.com<, reading ALL the many ECT articles…. Look for, and READ the book "Toxic Psychiatry" by Dr. Peter Breggin. You have a less than 10% chance of being "helped" by ECT. ECT "works" by causing mild (hopefully) BRAIN DAMAGE. That's how it "works". BRAIN DAMAGE. Of course all the quack shrinks say, is something like, "at this time, the exact mechanism by which ECT works is not completely understood", or some deceptive crap like that. Medical cannabis is far more likely to help you, than ECT ever could. The TRUTH is out there, but you won't get it from the pseudoscience drug racket known as "psychiatry"….

  • I had several courses of ECT when I was severely sick with treatment resistant depression. That whole period remains a memory blur. Since then I’ve had nearly 300 further maintenance treatments. My memory and cognitive function has returned to normal & I have been well. It saved my life.

    • Are you sure? Have you had an MRI or a neuropsychological test? There is a condition, particularly related to frontal lobe brain damage, called anosognosia. This is manifested by the inability of the individual to recognise impairments they may have. The more severe the impairment the less the person can recognise it.
      The fact that you have had so many ECT treatments indicates that it has not been of any lasting value and there is some evidence to suggest that your ongoing depression may have been caused by the electrical injury you were receiving.
      I have researched the neurological studies into electrical injury to the head rather than the more partisan psychiatric studies which set out to deny any damage.
      Here are some of the results, which only include a single injury, not the multiple injuries received by ECT recipients:
      `Immediate manifestations in survivors of electrical injuries include altered consciousness, confusion, disorientation, and amnesia – (Immediate post ECT effects)
      Subsequently, patients show either normalization of mental status or sequelae ranging from headaches and distractibility to persistent psychiatric disorder and dementia. The fact of this variety has been recognized for a long time.
      They found “persistent neurobehavioral disorder” in 75% of those whose injury was by direct current. In the remaining studies the individuals came to attention because of their complications, and almost all of them showed abnormalities such as depression and memory impairment.
      While disturbances of language, awareness, or visuospatial functions seem to be rare, impairments of attention, concentration, verbal memory, and new learning are very frequently identified.
      56% of subjects in the acute group and 68% of subjects in the post-acute group had component scores in the impaired range- (neuropsychological testing)
      Postelectric shock syndrome is a disorder of persistent cognitive and psychologic disturbances. Cognitive complaints and deficits resemble those in mild to MODERATE TRAUMATIC BRAIN INJURY. Psychologic disturbances range from specific phobias to MAJOR DEPRESSION.
      This is a small example of the findings from several studies.
      There is also the 2014 acknowledgement by Dr Charles Kellner, a major US proponent of ECT, that MRI studies clearly show damage to the structures of the brain following ECT. Such structural damage will manifest in cognitive and behavioural changes, recognised or not.
      – The basic fact is that a Traumatic Brain Injury (TBI),  results from damage to brain tissue caused by an external force and is defined as an alteration in brain function, or other evidence of brain pathology, caused by an external force.
      – ECT is an external electrical force (300 – 450 volts for 8 seconds) applied to the brain that causes loss of consciousness, and a seizure. These are serious alterations in brain function that, if seen in an ER will be treated as a medical emergency.
      – Therefore ECT causes a Traumatic Brain Injury (TBI)
      There is simply no question that ECT WILL cause damage to the brain with neurological consequences.
      It may be that your present state is comfortable enough for you to ignore this but I really suggest you do not embark on any more treatments. A loss of emotional acuity is a common outcome from repetitive TBI, so the pain of the depression may seem far away, along with other emotions, but continued use of ECT might result in early dementia. Many neurologists have issues with psychiatrists about this, and as far as I’ve seen psychiatrists admit that long term results of maintenance ECT have not been assessed.
      I wish you all the best.

    • Just a PS: Re “56% of subjects in the acute group and 68% of subjects in the post-acute group had component scores in the impaired range-” (neuropsychological testing)
      The remaining subjects may also have suffered a reduction in scores but they may not have registered in the `impaired range’.
      There is a circumstance in litigation over head injuries called `cognitive reserve’. It is used to assess the DEGREE of damage as well as disability. For instance In a person with very high premorbid cognitive abilities e.g. high intelligence, the loss of function may not reduce them to an `impaired’ state in tests. These tests are based on `average’ performance. So a person who, before their injury was classed as `gifted’ for instance, may be only reduced to `high average’ across all tasks, though they may have specific deficits that are much more reduced. The claim will be that this means that they are deemed to be functioning `well enough’. The court will then assess the actual LOSS suffered by the person, and may find that the reduction of ability, not the final scores of a test, are the most relevant issue.
      For the average person, a similar injury may well reduce them into a handicapped range.

    • Thank you for sharing your ECT experience. Many who consider having ECT have been encouraged by you !

    • Rob Griffin ….. my comment was made after your testimonial but someone chose to make it look like it was after a negative ECT comment ….. NOT GOOD POLICY ! …. so, here it is hopefully under Rob’s comments,
      n. bailey
      June 4, 2018 at 7:49 pm
      Thank you for sharing your ECT experience. Many who consider having ECT have been encouraged by you !

    • My comment is meant as a reply to Rob Griffins’ good ECT report ! It was placed several comments lower so it seems to be a negative instead of a positive for ECT !

  • Dr. Seiner, if you say that 60 ECT treatments within a year is completely safe and the patient should regain all of their memory within 3 to 6 months why don’t you do the same to prove that there is no risk other than some short term memory loss during the weeks you are receiving ECT. If it is completely safe why not do it yourself or do a control group. I mean after all it doesn’t cause any memory loss other than some short term memory loss while regularly receiving ECT treatments. Once you stop the weekly treatments your long term and short term memory should be back to normal. I think it could be very influential and show your patients and others howhelpful ECT can be, as you have said!

  • I am so sorry this happened to you. This man has given you a Traumatic Brain Injury (TBI) – Whatever anyone tries to tell you, there is no way your original condition can cause the symptoms of a Traumatic Brain Injury. Depression and anxiety DO NOT cause cerebral atrophy and haemorrhage.
    Sadly some of the consequences will be permanent, particularly the lost past memories. If you live in America your options may be far more expensive than they would be in a country with single payer health cover, but this is the path you need to follow:
    First- read up on TBI and the treatments available for it –
    Second – have an MRI to see what physiological damage can be seen (this may not show much as most of the damage is microscopic and can only be found in autopsies, but my bet is that there will be shrinkage and patches of cell death (don’t panic, we have a lot to spare).
    Third – have a neuropsychological test to assess the main areas of cognitive dysfunction (areas of memory, concentration, executive etc).
    Fourth – take this information to a NEUROLOGIST and ask to have neurological rehabilitation. If you can get this from a government program all the better because if they’re are flooded with calls for rehab by thousands of ECT victims they might re-think ECT restrictions. DON’T tell the neurologist how you came by the injury until after he has assessed your case. Just be vague and say you were concussed a few times. This way you’re establishing proof that you have had a TBI (many) which the psychiatrists deny happens. Remember doctors stick together, so they may try to dismiss you if you let on that you’ve even been a psychiatric patient.
    Fifth – Do take the rehabilitation as it can help. There is likely to be some clinical psychologists because you, like every victim of head injury are traumatised by the changes in your abilities and self perception which can lead to depression anxiety (DON’T TAKE ANY MEDS FOR THAT), and PTSD. There will be other therapists who can teach you how to manage your memory issues and can help you organise your life, something very difficult to do when you are brain injured and angry.
    My belief is that if enough ECT damaged people present to neurologists to get independent neurological confirmation of the damage, a case can be made, with the neurologists’ support, that ECT DOES cause permanent, and often devastating brain damage to all those who have it, even those who believe they are helped.
    Somehow we have to become recognised by affirmative ACTION, something very difficult for brain injured people who are too damaged to be able to protest but those of us who are capable must do it for those who are not.

  • THIS MAN CAUSED SO MUCH PAIN In MY LIFE. HE TOLD ME I WOULD GET THE MAJORITY OF MY MEMORY BACK IN 6 MONTHS ITS BEEN TWO YEARS I HAVE WAY LESS THAN HALF. I WOULDN’T HAVE CARED ABOUT THE HIGH SCHOOL YEARS I DON’T MIND forgetting those BUT IM ALMOST POSITIVE I HAD A HAPPY CHILDHOOD AND HE TOOK ALL OF MY MEMORIES OF HAPPINESS AWAY FROM ME. IF I HAD KNOWN BEOFRE GOING THROUGH WITH THE ECT I WOULDN’T HAVE DONE IT. THEY NEVER TOLD ME THAT THE MAJORITY OF MY LONG TERM MEMORY WOULD BE ERASED AND THEY FOR SURE DID NOT TELL ME THAT ECT WOULD CAUSE PERMANENTS SHORT TERM MEMORY LOSS I’M IN COLLEGE NOW AND I FEEL LIKE THERES NO USE IN TAKING A CLASS BECAUSE EACH WEEK I’LL HAVE TO RELEARN THE MATERIAL WHICH I WILL END UP FORGETTING THE NEST WEEK. MY CHILDHOOD WAS TAKEN AWAY FROM ME. I GET THAT IT IS HELPFUL TO SOME PEOPLE BUT THEY NEED TO TELL USE THE RISKS INVOLVED. THEY TELL US THERE WILL BE SHORT TERM MEMORY LOSS DURING THE TREATMENTS BUT THEY DON’T TELL US ANYThING AbOUT PERMANENT MEMORY LOSS AND IF THEY HAD I WOULD NEVER HAVE DONE IT. THIS HAS CAUSED EXTRA PAIN AND SUFFERING than I had even before starting the treatments.

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