Drugs, 'Shock Therapy' Beat Depression
Study Shows ECT and Antidepressants Are Effective Therapies
Shock Therapy Revisited
The reviewers call electroconvulsive therapy (ECT) “the most effective treatment for depression, especially if patients present with psychotic symptoms, such as delusions and hallucinations.”
Max Fink, MD, who is widely known as “the grandfather of American ECT,” tells WebMD that studies continue to show that the treatment is highly effective in depressed patients with psychosis.
He says ECT was all but abandoned in the 1960s when antidepressant drugs became available, but they found a following once again in the 1980s as a treatment for severely depressed patients who did not respond to drugs.
According to the American Psychiatric Association, there is no evidence that ECT causes brain damage. Anesthesia and muscle relaxants are given during the procedure. Also, ECT cannot be administered without consent.
The most common side effects of ECT are headache, muscle soreness, and confusion shortly after the procedure. Patients may also experience some short-term memory loss, which usually improves over time (days to months).
The American Psychiatric Association says:
"Some people who advocate legislative bans against ECT are former psychiatric patients who have undergone the procedure and believe they have been harmed by it and that the treatment is used to punish patients' misbehavior and make them more docile. This is untrue. It is true that many years ago, when psychiatric knowledge was less advanced, ECT was used for a wide range of psychiatric problems, sometimes even to control troublesome patients. The procedure was frightening for patients because it was then administered without anesthesia or muscle relaxants, and the uncontrolled seizures sometimes broke bones."
Vagus Nerve Stimulation
An epilepsy treatment that was just approved for the treatment of depression works in a similar way to ECT, but its effects may last longer.
Like ECT, vagus nerve stimulation (VNS) uses electrical charges to relieve the symptoms of depression. But unlike the older treatment, the charges are delivered by a surgically implanted device that works much like a pacemaker.
The silver-dollar-sized device sends out pulses of electricity to the vagus nerve, which transmits them to the brain.
The reviewers noted that VNS has been proposed as a treatment in drug-resistant and ECT-resistant depressed patients, but they concluded that the "evidence for its effectiveness is as yet inconclusive."