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New Shock Therapy Procedure Works With Fewer Side Effects

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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."

Vital Information:

  • 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 electrical energy.
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