New Shock Therapy Procedure Works With Fewer Side Effects
About two-thirds of patients responded to the high-dosage treatments. These
response rates were about twice that as seen in the low-dosage and
moderate-dosage groups who received a shock to one side of the brain.
However, the high-intensity treatment to the right side of the brain
produced less severe and persistent bad side effects on learning and memory
than the treatments involving both sides of the brain. One week after
treatment, patients who received a shock to both sides of their brains were 71%
more likely to not remember facts about their lives that they had reported at
the beginning of treatment.
In the second study, W. Vaughn McCall, MD, MS, and colleagues found that the
best results were achieved through higher doses of electricity. "You need
to use relatively large doses," says McCall, who is with the departments of
psychiatry and behavioral medicine at Wake Forest University School of Medicine
in Winston-Salem, N.C. "But we also had more side effects" at those
levels, McCall tells WebMD.
McCall says that in 1990, the American Psychiatric Association's Task Force
on ECT suggested that a moderate dose of electricity to the right side of the
brain should be used. But doctors interpreted this to be a level that didn't
help "nearly as many people as would be expected."
As far as side effects, McCall urges physicians and patients to consider
what are the most important goals of therapy: the antidepressant response or
avoidance of side effects. He says that most memory problems seen after
treatment are only temporarily bothersome to patients. Problems with being able
to remember events after therapy are seen within the first two weeks following
treatment, but soon return to normal. Patients do experience some permanent
loss of memories that were made prior to treatment.
"For most patients, this is not a big deal," says McCall. "I
always discuss this with my patients prior to ECT. It is almost never an issue
for them. Their memories of being depressed are not too precious to them, and
they're willing to sacrifice them."
- Electroconvulsive therapy (ECT), or shock therapy, is used to treat
depression in patients who do not respond to other treatments, such as
medication or psychotherapy.
- One side effect of the treatment is memory loss, but new research shows
that giving ECT at a higher intensity to only one side of the brain, instead of
both sides of the brain, reduces the chance of memory loss.
- Currently, U.S. physicians cannot administer treatment in this manner,
because the FDA does not allow the machines to deliver these higher doses of