New Shock Therapy Procedure Works With Fewer Side Effects
All those who spoke with WebMD reiterated the need for equipment that would allow high-intensity stimulation to the right side of the brain. A FDA spokesperson tells WebMD that the Center for Devices and Radiological Health has to review the relevant material and has no official response at this time.
In the first study, Harold A. Sackeim, PhD, and other investigators at the Columbia University College of Physicians and Surgeons in New York compared the effects of giving low, moderate, and high levels of shock to one side of depressed patients' brains, and giving a moderate level of shock to both sides. Depression and mental function were assessed before, immediately after, and two months after the treatment. Cognitive tests included an evaluation of different types of memory function, including the ability to remember events prior to treatment and after treatment. Patients were monitored for relapse for a year.
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."