Controversial Electroconvulsive Therapy Helps Severe Depression

Passing an electric current through the brain to induce a seizure is not everyone’s idea of a therapeutic procedure. So it's no surprise that electroconvulsive therapy (ECT) has been controversial. Fears of misuse are common, and efforts to restrict or abolish the practice have had some success. Yet ECT persists because it can be a uniquely effective treatment for severe depression and other mental illnesses, reports the February 2007 issue of the Harvard Mental Health Letter.

The treatment affects many brain pathways, nerve receptors, neurotransmitters, and endocrine systems. Before the advent of ECT, drugs were used for the same purpose, but were less effective and had more serious side effects.

The most common side effect of ECT is memory loss. Tests show that memory—both the ability to recall earlier events and the ability to absorb new knowledge—declines with ECT. Memory usually returns to normal within a few weeks, but not necessarily for all patients and in all respects. The way the treatment is done may make a difference. For instance, research suggests that placing both electrodes on the same side of the head, using intermittent pulses instead of continuous stimulation, and lowering the dose of electricity can greatly reduce the risk of memory loss.

“ECT continues to restore the health and sometimes save the lives of people with the potentially lethal disorders of severe depression, mania, and acute psychosis. For the patients who suffer most with mood symptoms, nothing better than ECT has been devised,” says Dr. Michael Miller, editor in chief of the Harvard Mental Health Letter. “That is the most important reason for its survival through doubts, fears, and political controversy.”

Also in this issue:
• PTSD risk
• Voice of conscience
• Obesity and depression
• Behavioral vs. cognitive therapy
• Alcoholism and the brain
• A doctor discusses: Brand-name vs. generic drugs

Source: Harvard Mental Health Letter