Posted by blueboy on June 1, 2008, at 18:51:45
In reply to ECT report » Racer, posted by Crotale on June 1, 2008, at 13:16:51
I've never had it. I went to a special diagnostic clinic which gave me a positive and convincing diagnosis of Bipolar II, for the first time in my life. I was one step from ECT as no antidepressants have worked well over the decades.
Anyway, I thought I would share some facts mixed with my opinions and impressions from a long bout of research I did when I was thinking about having it done.
1. The medical establishment has done a very poor job with objective, standardized ECT research, especially considering the length of time the procedure has been used (well over 50 years!), the considerable expense of the procedure (over $1000 per treatment for 7-12 treatments, I think), the inherent danger and high degree of patient trauma -- I mean, any procedure that requires deep anesthesia is per se serious, since the anesthesia itself has a mortality rate (I have heard .1%). Not to mention the occasional and unquantified reports from some patients of extreme mental damage.
There has been little actual double-blind testing of even short term memory loss, and what research I have seen is elementary with no qualification of the testing. The studies I have seen are so poorly designed that anyone with a bare acquaintance with research methodology should be aghast.
I have never seen even a hint of a rational, objective protocol for ECT based on individual patient reaction.
The psychiatric community really should be ashamed of itself. Profound long-term memory and even cognitive disturbance does occur. The main reaction to these cases, at least by pro-ECT commentators, seems to be to ascribe it to pre-existing memory deterioration, with no attempt at quantification or testing. The APA uses a figure of 1 in 200 cases suffering serious long-term mental effects, with no solid citation to research that would support it.
Almost the only long-term studies of significant populations involve Texas (and, I think, California), where laws have been passed requiring records of ECT treatment and minimal reporting of short-term side effects, but even these (as I recall them) lack longer-term assessment.
I don't want to sound like there have been no studies or research in the area. I just haven't found anything that approaches the breadth or sophistication that the procedure would warrant under the circumstances.
It is impossible to discount a number of people who claim that their minds have been ruined by ECT. The only response I have seen from the pro-ECT psychiatrists is "pooh-pooh", in effect, "these people were losing their minds anyway". Not impressive.
2. On the other hand, a lot of very good psychiatrists -- who are not monsters or modern-day Joseph Mengeles -- report abundant anecdotal evidence of excellent results for drug-resistant depression with ECT with tolerable side effects, especially when occasional ongoing treatment is given. (Again, repeated or adjunct treatements appears to be totally ad hoc, but one treatment every six months seems to me to be typical) and/or adjunct drug therapies.
The efficacy of ECt in some cases is nothing new. Sylvia Plath took the name of her great novel, "The Bell Jar", from the feeling she got after ECT (and this was in the 1960's) -- she felt as if she had been living in a bell jar vacuum all of her life, and suddenly, after receiving ECT, the bell jar was removed.
I had personally decided I would try sine-wave unilateral ECT rather than face a lifetime of depression and potential suicide. But thank heaven, I found out my condition is Bipolar II (which as far as I could tell has less success from ECT) rather than major depression before I did it.
poster:blueboy
thread:832202
URL: http://www.dr-bob.org/babble/20080528/msgs/832397.html