05/22/18

To Shock or Not to Shock

To shock or not to shock; that is the question. Is electroconvulsive therapy (ECT) an effective and safe treatment for severe cases of mood disorders such as depression? Or is it something that “permanently impairs memory and causes other long term signs of mental dysfunction such as difficulties with concentration and new learning?” It continues to be one of the most controversial treatments used in medicine because “precisely why electroshock works is a mystery.” And it’s also because it has a history of being used as a form of torture and euthanasia by at least one Nazi doctor.

In October of 1939, shortly after the invention of ECT by two Italian researchers, Adolf Hitler signed a decree that authorized German doctors to euthanize any psychiatric patient who was deemed incurable. “Between 1939 and 1941, tens of thousands of patients were killed at psychiatric hospitals.” While the program officially ended in 1941, the practice continued until the defeat of Germany in 1945 particularly with Dr. Emil Gelny. After just three months of clinical training, Gelny was granted a specialist qualification in psychiatry in 1943 and placed in charge of two psychiatric hospitals in Austria. At first, he used lethal doses of drugs like morphine and barbiturates to kill ‘incurable’ patients, but when the drugs became scarce, he modified existing ECT machines.

After the initial shock rendered the patient unconscious, he added four extra electrodes and attached them to the person’s wrists and ankles to deliver the lethal shocks. In “Mass killing under the guise of ECT,” the authors wrote: “Besides its easy availability and cost-effectiveness, a further important factor was that ECT could be camouflaged as a medical procedure to reduce patients’ suspicion, at a time when many correctly feared that drugs were used to kill them.” The author of “How Electroconvulsive Therapy Became a Nazi Weapon” said it was not clear how many individuals Gelny murdered with ECT. The combined death toll at the two hospitals was 4,800, but most patients likely died from drug overdoses or malnutrition. For more information on the Nazi use of psychiatry in euthanasia, see “Psychiatry’s role in the holocaust.”

Supporters of ECT like Dr. Jeffrey Lieberman say that modern ECT technologies allow for individualized treatment for each patient so the minimum amount of electricity needed to induce a seizure is used. Allen Frances, the chair for the DSM-IV, said on Twitter that if he had severe depression, “ECT would definitely be my 1^st choice.” The use of anesthetics combined with muscle relaxants and oxygenation “render ECT an extremely safe procedure,” according to Dr. Lieberman. He thought it was extremely ironic that the inventors of ECT failed to even be nominated for a Nobel Prize, “despite the fact that their invention was the only early somatic treatment to become a therapeutic mainstay of psychiatry.” He noted where the APA, NIH and FDA all approve the use of ECT “as a safe and effective treatment for patients with severe cases of depression, mania, or schizophrenia, and for patients who cannot take or do not respond to medications.”

On the other side of the ECT debate is Dr. Peter Breggin, who has been personally and professionally fighting against the use of ECT for over thirty years. You can review a wealth of information, including over 150 scientific studies by him and others, on his website: ECT Resources Center. One of his ‘key articles,’ “The FDA should test the safety of ECT machines” was written in 2010 to inform the FDA about the damaging effects of ECT as it was considering a reclassification of ECT treatment as safe for depressed patients. Breggin’s opening comment was: “Since its inception in the late 1930s, electroconvulsive therapy (ECT) has never been subjected to testing for Food and Drug Administration (FDA) approval in regard to safety and effectiveness.”

He said ECT is acknowledged, even among staunch advocates of the procedure, as the most controversial treatment in psychiatry. The Consensus Development Conference on ECT, conducted by NIH, was cited as affirming that assertion. “Given this extraordinary degree of controversy, there can be no justification for not subjecting ECT to the same scrutiny that is given to devices and treatments that are far less controversial, including at the least new animals studies.” Since it causes an acute delirium, there is no scientific doubt ECT harms the brain and mental function.

ECT produces sufficient trauma to the brain to cause a severe grand mal convulsion. All ECT treatments result in a period of coma lasting several minutes or more, sometimes including a flat line EEG. In routine application, the patient awakens in a delirium that is virtually indistinguishable from any other closed head injury. Typical symptoms include severe headache, memory dysfunction, disorientation, confusion, lack of judgment and unstable mood. The treatment always results in apathy, and sometimes in euphoria, which are typical reactions to traumatic brain injury. Consent forms routinely warn patients not to make decisions during or shortly after the completion of any series of ECT treatments.It is acknowledged in neurology that repeated head injuries that produce concussive symptoms are likely to cause persistent harm. ECT treatments are far more traumatic than most concussions, and include prolonged coma after each treatment, sometimes accompanied by EEG flat lining, and severe delirium after a few treatments or less. The number of traumatic ECT treatments usually far exceeds the number of concussions that produce lasting harm.In the rational practice of regulatory affairs, the fact that a treatment causes such initial trauma would in itself require it to be withdrawn from the market; it certainly requires a thorough examination of ECT by the FDA, starting with animal studies.

He referred to large animal studies that demonstrated generalized brain damage from ECT. He pointed to a 2007 study confirming that ECT produces lasting memory dysfunction and more generalized persistent cognitive deficits. “Except in regard to a psychiatric treatment, substantial evidence on this scale for persistent damage would lead to an inquiry into withdrawing a treatment from the market.” And despite several decades of effort, ECT advocates have not been able to demonstrate any lasting improvement.

The Consensus Development Conference on ECT found that controlled clinical trials failed to demonstrate any positive effect beyond four weeks. Thus the risk/benefit ratio is very poor. This four-week period corresponds to the period of the acute delirium, when the ECT effects of emotional blunting and/or euphoria are mistaken for clinical improvement. Typically, the patient stops voicing complaints and may display an artificially elevated mood.

The result of the hearings was a FDA advisory panel recommended in 2011 that ECT devices be designated as high risk for all patients: “FDA panel advises more testing of ‘shock-therapy’ devices.” Note the contradiction to what Dr. Lieberman claimed.

FDA staffers who reviewed hundreds of studies reported that as a group, they were poorly designed and had too few patients to allow firm conclusions to be drawn. “Many failed to follow patients long enough to discover the duration of ill effects.” The majority of the 18-member committee said not enough was known about ECT and more research was needed into the usefulness and hazards of the ECT devices.

That ruling led to an ongoing controversy, with the FDA tabling the issue until in 2015 it drafted a ‘proposed order’ that 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. However, it would also impose new requirements, like requiring physicians to warn patients that the side effects of ECT can include confusion and memory loss, and that its long term safety in not proven. They would also have to monitor patients’ memory and cognitive skills before and during treatment. “And the FDA would also classify ECT as high risk for psychiatric conditions other than depression and for children and adolescents.”

STAT News said psychiatrists are concerned that classifying ECT as a high risk procedure for psychiatric conditions other than depression, and for children and adolescents “could prompt insurers to stop covering and doctors to stop recommending ECT for younger patients” and those with other psychiatric conditions, like schizophrenia, bipolar mania and catatonia. It would require ECT manufacturers to conduct clinical trials for these indications. “It’s widely expected they will decline to do so because of the cost.” Doctors could still provide ECT “off label,” but insurance companies could refuse to pay. “And physicians may worry about the potential for malpractice lawsuits if anything goes wrong.”

Stop and think for a minute about these last statements. ECT device manufacturers are expected to decline to do expensive clinical trials to confirm that their device is safe and effective for patients who are children, adolescents, and suffer from psychiatric conditions other than severe depression. If there were studies provided to the FDA in 2010 to support the use of ECT to treat these populations, they were poorly designed and had too few patients to allow for conclusions to be drawn. So they have been using ECT devices to treat these populations without reliable clinical trial evidence. And apparently the doctors who do ECT want to continue doing so without worrying about “the potential for malpractice lawsuits if anything goes wrong.”

The American Psychiatric Association and the consumer group NAMI (National Alliance of Mental Illness) think the FDA should classify ECT as moderately risky for all conditions for which it is now commonly used. The FDA received 2,040 comments on its draft rule during the public comment period closed in March of 2016. “The agency has not given a timetable for issuing a final rule.”

While we await the FDA decision on its draft guidance for ECT devices, consider these comments from Peter Breggin’s “Introductory Information About ECT”:

After one, two or three ECTs, the trauma causes typical symptoms of severe head trauma or injury including headache, nausea, memory loss, disorientation, confusion, impaired judgment, loss of personality, and emotional instability. These harmful effects worsen and some become permanent as routine treatment progresses.ECT works by damaging the brain. The initial trauma can cause an artificial euphoria which ECT doctors mistakenly call an improvement. After several routine ECTs, the damaged person becomes increasingly apathetic, indifferent, unable to feel genuine emotions, and even robotic. Memory loss and confusion worsen. This helpless individual becomes unable to voice distress or complaints, and becomes docile and manageable. ECT doctors mistakenly call this an improvement but it indicates severe and disabling brain injury.Abundant evidence indicates that ECT should be banned. Because ECT destroys the ability to protest, all ECT quickly becomes involuntary and thus inherently abusive and a human rights violation. Therefore, when ECT has already been started, concerned relatives or others should immediately intervene to stop it, if necessary with an attorney.

Meanwhile, two Pennsylvania state representatives are not willing to wait and see what the FDA recommends. They introduced a bill to prohibit the use of ECT on individuals age 16 and under. The co-sponsors thought it was deplorable when ECT was done to children who have no say on whether to agree or not to the treatment. One of them said he thought it was a form of child abuse. According to the Pennsylvania Department of Human Services, 13 children under the age of 5 were given ECT in 2014. Three adolescents between 13 and 17 were electroshocked as well that year. “Children should not be forced to undergo a treatment that can have a lasting impact on their physical and mental well-being.”

Also see: “The Frankenstein Monster of ECT,” “Is ECT Brain Disabling?” and “The Appalling Silence on ECT” on this website.

09/20/16

Appalling Silence on ECT

Kenny was put on antidepressants at the age of 14 because he was struggling in a difficult family situation. His symptoms became worse. The psychiatrist added another drug with again worsening symptoms. At one point, he was taking six different psychiatric drugs. Kenny was eventually told his depression was “treatment resistant” and needed electroshock therapy. “The risks were downplayed.” He was given 30 rounds of ECT and went from a high school honor student to having to be retaught how to tie his shoes. Wait, there’s more!

Kenny lost all memories of childhood and all memories of high school. He says it’s an identity crisis. He suffered severe headaches for a year and a half after the shocks and had to see a cardiologist because ECT left him with heart arrhythmia. Testing by a neurologist, done six months after the shocks, showed a loss of 50 IQ points compared to his high school IQ. Kenny still suffers from night terrors about the shocks.

Dr. Langemann’s article on “Shock Therapy” for the Huffington Post also referred to a biomedical engineer who said the “brief pulse” of ECT is actually a series of several hundred pulses, and not a single pulse. These pulses overstimulate brain cells, causing rapid random firing, intentionally causing a Grand Mal seizure. “The current causes overheating inside the brain and the electric field can tear holes in the cells (which causes the cells to die).” She noted that a conservative estimate is that 100,000 patients per year receive ECT.

Incredibly, ECT has never been through the standard clinical trial process to prove its safety or efficacy. Although the FDA has had the authority to regulate medical devices since 1976, it disregarded ECT machines because they’ve been in widespread use since the 1950s, according to STAT News in “Psychiatric Shock Therapy.” The FDA placed ECT machines in the class III (high risk) category where they have remained since that time. But in December of 2015, the FDA made public a draft document proposing to reclassify ECT machines as a class II (low risk) device. Before the public comment period ended in late March of 2016, the FDA had received 2,040 comments on its draft rule. The agency has not set a timetable for issuing its final ruling.

While the proposed regulations would indicate that ECT was “safe and effective” and only moderately risky for adults, it would only be approved for adults with severe depression who haven’t responded to medication or other therapies. It would remain classified as a high risk (class III) for psychiatric conditions other than major depression and for children and adolescents. There would be new requirements as well. Doctors would have to warn patients of the side effects of ECT, which include confusion and memory loss; and that long-term safety for ECT is not proven.

Psychiatrists warn that that these new regulations could lead to insurers not covering ECT and doctors not recommending it for younger patients and those with conditions like schizophrenia, bipolar disorder and catatonia. (They say it like that’s a bad thing) Charles Kellner, a professor of psychiatry at the Icahn School of Medicine said, “Its use for these indications is widespread, even ubiquitous, and to deny the extensive evidence in support of that is indefensible.” Supporters say ECT has come a long way since it was portrayed in “One Flew Over the Cuckoo’s Nest.” Patients get anesthesia and sedatives to minimize pain and muscle spasms, so they are less likely to hurt themselves during the ECT seizure. “Ultra-brief pulse therapy delivers a fraction of the electricity used in the past.” However, as noted above, this claim is disputed. See “The Frankenstein Monster of ECT” and “Is ECT Brain Disabling?” on this website.

Writing for GlobalResearch, Dr. Gary Kohls described ECT “therapy” sessions as: “sub-lethal electrocutions of the brain that reliably produces seizures and coma.” He noted that the perceived improvement with ECT is often because of the frequent short-term and long-term memory loss that occurs with shock treatment. “The patient may no longer remember the traumatizing interpersonal/sexual/social/ psychological/spiritual conflicts that previously made them feel sad, nervous, depressed, anxious or hopeless.” He lamented that studies show physicians reach for their prescription pad within minutes of most clinic encounters. “Time is money.”

Dr. Kohls then quoted excerpts from the testimony of Leonard Roy Frank before the Mental Health Committee of the New York State Assembly in 2001. Mr. Frank was a psychiatric survivor and activist who personally experienced 35 ECT procedures and 50 insulin coma treatments. The transcript of his testimony can be read here in its entirety. He said:

This was the most painful and humiliating experience of my life. My memory for the three preceding years was gone. The wipeout in my mind was like a path cut across a heavily chalked blackboard with a wet eraser. Afterwards I didn’t know that John F. Kennedy was president although he had been elected three years earlier. There were also big chunks of memory loss for events and periods spanning my entire life; my high school and college education was effectively destroyed. I felt that every part of me was less than what it had been.

Frank then elaborated on some of the adverse effects from ECT. With regard to memory loss, he indicated that the APA downplays memory loss, saying most patients actually report improved memory; and only a minority of patients report problems with memory loss. He said the vast majority of individuals he has talked to reported moderate-to-severe amnesia going back two years and more from the time they received ECT. His own experience was noted above.

Quoting the 2001 APA Task Report on ECT, Frank noted where a reasonable ECT-related mortality rate was suggested to be 1 per 10,000 patients. However, some studies show the ECT death rate is about one in 200. This rate may not still be accurate, as an increasing number of the elderly are being electro shocked. “Statistics based on California’s mandated ECT reporting system indicate that upwards of 50 percent of all ECT patients are 60 years of age and older.”

Frank described what he referred to as “the myth of informed consent.” While outright force is seldom used, “genuine informed consent is never obtained” because ECT specialists minimize the procedure’s nature and effects to candidates and their families; and because of the implicit coercion that can be brought to play. There is a lack of accountability with psychiatry. It was a “Teflon” profession, meaning what little criticism there is doesn’t stick. “Psychiatrists routinely carry out brutal acts of inhumanity and no one calls them on it — not the courts, not the government, not the people.”

Electroshock could never have become a major psychiatric procedure without the active collusion and silent acquiescence of tens of thousands of psychiatrists. Many of them know better; all of them should know better. The active and passive cooperation of the media has also played an essential role in expanding the use of electroshock. Amidst a barrage of propaganda from the psychiatric profession, the media passes on the claims of ECT proponents almost without challenge. The occasional critical articles are one-shot affairs, with no follow-up, which the public quickly forgets. With so much controversy surrounding this procedure, one would think that some investigative reporters would key on to the story. But it’s happened only rarely up to now. And the silence continues to drown out the voices of those who need to be heard. I’m reminded of Martin Luther King’s 1963 “Letter from Birmingham City Jail,” in which he wrote: “We shall have to repent in this generation not merely for the vitriolic words and actions of the bad people, but for the appalling silence of the good people.”

Psychiatrist Peter Breggin has advocated against ECT for decades. You can watch an 11-minute video he did called, “Electroshock is Brain Trauma.” He indicated the 100,000 per year estimate for ECT was based on data he gathered in 1979 for his book critical of shock treatment. He said today every large city has several places that do shock treatment. “It’s extremely remunerative.”

Dr. Lagemann indicated that standard treatment is 9 to 12 shocks, at a cost of $2,000 to $2,500 each. When you do the math, you come up with a minimum income of $1.8 billion (9 x 100,000 x $2,000 = $1.8 billion). About half the cost is covered by Medicare. Mr. Frank indicated that in 2001, psychiatrists specializing in shock treatment earned $300,000-$500,000 a year compared to other psychiatrists whose mean annual income was $150,000.

What’s wrong with shock treatment? How does it work? It’s not as mysterious as the advocates make out. Shock works by passing an electric current through one or both frontal lobes of the brain, producing an electrical lobotomy. The electricity also passes through the memory centers of the temporal lobe, causing additional devastation. Finally, the current passes throughout the brain and that, along with the severe seizures that result, causes widespread brain dysfunction and damage. Some patients initially become euphoric from the damage, whereupon the shock doctor notes approvingly, “mood elevated.” All patients eventually become apathetic and indifferent, and unable to resist, whereupon the doctor notes with finality about the outcome, “no longer complaining.”

Dr. Breggin said the only reason that modern shock doctors don’t talk about ECT as damaging the brain is because he publicized and documented how it was in his book, Electroshock: Its Brain-Disabling Effects. He noted that when ECT treatment is done, it results in a period of coma. “How could a blow to the brain with electricity so severe it causes a coma, and you’re not harmed by it?” Very often the EEG brain waves flat line—that’s temporary brain death. The person wakes up completely disoriented. The longer the treatment continues, the more past memory the person loses.

The STAT News article noted where a woman who had 66 ECT treatments between 1996 and 2010 to treat depression left such holes in her memory that she couldn’t recall her wedding day or the birth of her children. Her 28-year marriage ended, ““because I couldn’t remember that relationship, and without those memories, I had no emotional connection.”

Dr. Breggin created a free website about shock treatment: ECT Resources Center. Among its documents is a simple introductory statement and brochure for widespread distribution. There are also PDFs of more than 100 scientific articles on issues with ECT. He urged people to do everything they can to stop someone they know getting ECT, because they will never be the same afterward.

As of September 1^st, there has not been an announcement of what the FDA plans to do with ECT. But when the FDA announced it was soliciting comments of the proposed regulatory changes, the American Psychiatric Association created a form letter for psychiatrists to “take the lead in expressing their views” regarding the role of ECT in clinical practice and treating major depressive disorder. See “Time is Now to Support the ECT Reclassification Effort.” The letter asserted that ECT was an important treatment option for some people with severe mental health conditions. “Your proposed reclassification will greatly improve access to safe, effective treatment for individuals with serious and persistent psychiatric disorders.” You can download and read a copy of the form letter in the above link. I wonder how many of the 2,040 comments were APA form letters from psychiatrists?

01/21/15

The Frankenstein Monster of ECT

In his article on electricity and 19th century medicine, Dr. Matthis Krischel argued that Mary Shelley’s novel, Frankenstein, could be read as a Victorian science fiction novel that sought to imagine the medical possibilities of electricity. In the era where the scientific method was established within the biomedical sciences, Shelley’s novel raised the question of what the experimenter could ethically do to living, as well as dead bodies. That very same question continues to be debated today over the use of ECT (electroconvulsive therapy) to treat depression.

Krischel asked what physicians can learn from 19th century’s medical experiments with electricity. He commented that like the early 19th century, new technologies and therapies can instill fear in the public or individual patients. “Medical practitioners must take these reactions seriously and address them as well as use the tools of their trade responsibly in order not to turn loose another Frankensteinian monster.”

When reading the literature critical of ECT, I had an eerie déjà vu experience of Krischel’s description of the 19th century experiments with electricity in medicine. Philip Hickey reviewed an article by Max Fink, a supporter of ECT, celebrating 80 years of convulsive therapy. Even a mostly positive history of ECT written by Norman Endler in 1988, “The Origins of Electroconvulsive Therapy (ECT)”, acknowledged that ECT was controversial. The nature of ECT treatment, its history of abuse, unfavorable media presentation (Think “One Flew Over the Cuckoo’s Nest”), and compelling negative testimony by former patients paints a Frankenstein-like atmosphere at times.

Disturbingly, in “ECT: shock, lies and psychiatry,” Yvonne Jones and Steve Baldwin reported that during the very first ECT experiment on a human, the patient’s very clear objections were ignored. “Despite the man’s expressed wishes, Cerletti proceeded with his experimentation, and using a higher voltage, induced a convulsion.”

Peter Breggin has been a long time activist against ECT, going back to before his 1979 book, Electroshock. Dr. Breggin made this book, along with more than 125 scientific articles on injury from ECT, available on his ECT Resources Center website. He has also provided links to information on ECT from other sources, including his website, blogs and scientific articles he’s written.

In a 2010 article on ECT, Breggin noted that ECT therapy, and “the machines that deliver it,” have never been tested by the FDA for safety and efficacy. He gave an overview of several disturbing findings with ECT.

The “treatment” process of ECT delivers sufficient trauma to the brain to cause a severe grand mal seizure. “There can be no scientific doubt that ECT harms the brain and mental function. The only controversy surrounds the severity and persistence of the harm.”
New evidence (here and here) confirms that ECT produces lasting memory dysfunction and other cognitive deficits. It contradicts claims by shock advocates “that ECT does not cause brain damage.”
ECT is frequently used with the elderly, where it causes even more severe dysfunction to the fragile, older brain.
Despite several decades of effort, no lasting improvements from ECT can be demonstrated. “The Consensus Development Conference on ECT found that controlled clinical trials failed to demonstrate any positive effect beyond four weeks.” There’s no clear evidence of a reduction in suicide risk. Several studies have shown that a placebo ECT procedure produces as much improvement as ECT itself, “without any of the risks.”

In a 1998 article, Dr. Breggin gave an extensive review of the problems resulting from ECT treatment. One of the more disturbing ones to me was that of iatrogenic [caused by medical treatment or examination] helplessness and denial. Consistent with other individuals with central nervous system damage, ECT patients minimize or deny their real losses of mental function. Think of someone you know with dementia or Alzheimer’s. “Interviews with family and friends of patients often disclose that they are painfully aware of the damage done to their loved ones. Often, the psychiatrist is the only one who consistently and unequivocally denies the patient’s damaged state.”

At the Consensus Conference on ECT in 1985, critics and advocates debated whether there was any benefit from ECT. “The advocates were unable to come forth with a single controlled study showing that ECT had a positive effect beyond 4 weeks.” Breggin commented how this confirmed the brain-disabling principle of ECT, since “4 weeks is the approximate time for recovery from the most obvious mind-numbing or euphoric effects of the ECT-induced acute organic brain syndrome.”

Matthis Krischel correctly observed that Frankenstein could be read in a way that imagined the medical possibilities of electricity. Shelley eloquently captured the just discussed temporary mood-lifting effects of ECT:

For a moment my soul was elevated from its debasing and miserable fears to which these sights were the monuments and the remembrances. For an instant I dared to shake off my chains, and look around me with a free and lofty spirit; but the iron had eaten into my flesh, and I sank again, trembling and hopeless, into my miserable self.” (Mary Shelley, Frankenstein)

09/10/14

Is ECT Brain Disabling?

I’ve only had a couple of up-close-and-personal experiences with people who have had electroconvulsive therapy (ECT). Both were residents of a long-term addiction treatment facility for women. One woman was in her late 20s who didn’t appear to have suffered any serious side effects after her ECT treatment. But the ECT didn’t seem to have a clearly positive effect on her depression. Actually, her mood seemed rather flattened afterwards.

The other woman had been a resident for a few months and suffered a severe depressive episode for which she agreed to have ECT. A small group of the residents gathered around her when she returned from her stay and ECT treatment at Western Psychiatric Institute and Clinic (WPIC). The other residents were supportive, asking how she was doing; telling her they were glad to see her, etc. She responded in a quiet, timid manner, thanking them for their support. As the group broke up and we entered the facility, she whispered to me: “Who were those people?”

Since then, I’ve read some of the material of the opponents to ECT, particularly Peter Breggin, who has a long history of activism against ECT. Dr. Breggin, has gathered an incredible amount of information on the website ECT Resources Center.

So I was interested when I saw an online article in the Pittsburgh Post-Gazette in December of 2013 on ECT treatment at WPIC, “Electroconvulsive therapy a surprisingly common treatment for mental illness.” The psychiatrist who treated the woman in the article said that ECT “is the most effective antidepressant still out there.” The article was clearly positive about the use of ECT, but a sentence stood out to me: “Doctors are still not sure why ECT works.” Yet, Dr. Breggin wrote on his website:

ECT works by damaging the brain. The initial trauma can cause an artificial euphoria which ECT doctors mistakenly call an improvement. After several routine ECTs, the damaged person becomes increasingly apathetic, indifferent, unable to feel genuine emotions, and even robotic. Memory loss and confusion worsen. This helpless individual becomes unable to voice distress or complaints, and becomes docile and manageable. ECT doctors mistakenly call this an improvement but it indicates severe and disabling brain injury.

A 78-year-old Beaver Falls woman, who had been treated for a bipolar disorder since the 1960s, was the featured patient in the Post-Gazette article. The reporter, Mark Roth, was permitted access to observe her ECT treatment. He wrote that she was unconscious and her muscles were paralyzed from anesthesia, “It was over in 8 seconds. . . . For her and for anyone watching, it was far less dramatic than they might have imagined.” After her series of 10 shock treatments, the woman felt that ECT helped her tremendously. She said that ECT made it possible for her to climb out of the deepest depression she had ever experienced.

The comment of ECT being “far less dramatic” was an allusion to the 1975 movie “One Flew Over the Cuckoo’s Nest,” where Jack Nicholson’s character was held down by attendants as he went through ECT treatment and the resultant seizure.

The modern use of anesthesia and muscle relaxants means that physical restraint, as portrayed in the movie, no longer occurs. But as Dr. Breggin pointed out in a debate with Dr. Helen Lavretsky, anesthesia makes it more difficult to initiate a seizure, so the patient has to have a greater shock than was given in the past. Listen here to the debate with Dr. Helen Lavretsky located on the ECT Resources Center website.

Dr. Lavretsky said that ECT was rarely performed, but Dr. Solia of WPIC, said that was a common misconception, at least at WPIC. He said that WPIC was one of the largest operations in the nation, performing “more than 300 electroshock procedures per month.” An assembly line procedure had “one set of patients being prepped with IV lines as another one is getting the treatment and still others are coming back to consciousness in a recovery area.”

There hasn’t been any follow up to the Post-Gazette article, even though the original article did say it was the “first of five parts.” In preparing my own article, I read the comments to the original article and I think I understand why. What was supposed to have been a positive public relations story about the ECT clinic at WPIC became a lightening rod that attracted strong negative attention. The majority of comments were negative like the following:

Not everyone’s ECT experiences are as positive as this article suggests. After my ECT I lost all memories of the year of my life before the treatments. This caused social and professional problems, as you can imagine, and also considerable personal pain. I also acquired some cognitive deficits with which I continue to struggle. (Sonia)I found ECT severely traumatizing, rendering profound memory loss that continues to manifest itself even 1 1/2 years later. I continue to suffer with cognitive defects and emotional pain that interfere with my work, social and personal life. I have repeatedly encountered others with very negative experiences. ECT does have positive results in some, but there are many for whom the treatment fails and wreaks havoc. (Kelly)

At least some of the individuals thought the article sounded like a “PR piece.” Cheryl asked: “Why not write another piece of equal length, focusing on the points of view medical professionals and former patients and their families who have the opposing viewpoint.” Don’t continue to wait for that to happen. I don’t think there will be any follow up articles. Just go to Dr. Breggin’s ECT Resources Center and get credible information on the problems with ECT.

Faith Seeking Understanding

Charles Sigler, D.Phil.

Tag: ECT Resources Center

To Shock or Not to Shock

Appalling Silence on ECT

The Frankenstein Monster of ECT

Is ECT Brain Disabling?