Shock Therapy: No Longer So Shocking
ECT as Depression Treatment Is Neither Curse nor Cure
Feb. 15, 2006 - Shocking news: Shock therapy for depression isn't evil.
Shock therapy makes many of us -- and many mental health professionals -- think of Jack Nicholson being zapped into oblivion in the movie One Flew over the Cuckoo's Nest. Even the real name for the treatment is scary. ECT: electroconvulsive therapy. How can this be good?
The answer, a new study shows, is that ECT can restore quality of life to people devastated by severe depression. Study leader W. Vaughn McCall, MD, leads the department of psychiatry and behavioral medicine at Wake Forest University School of Medicine.
"To take a universal, damning approach to ECT -- to say it ruins everybody's life -- is just not supported by this data," McCall. "The majority of patients in our study said they were better off after ECT. That is the importance of this study. It refutes global claims that this is a life-destroying treatment."
The study appears in the February issue of the Journal of Affective Disorders.
ECT: The Not-So-Shocking Truth
McCall says ECT is not a cure for depression. Its effects wear off. He'd never use it unless psychotherapy and medication failed to bring a patient back from the depths of depression. He's quick to point out the treatment's shortcomings.
"There are a lot of reasons not to do ECT. But people think it is painful, bone breaking, and brain damaging. That is not the case," McCall says. "The reason to be concerned is that it is costly. It is a hassle -- you can't do it at home. And it is not permanent. Even if you get a great result, it may not stick."
And, McCall is quick to point out, there is short-term learning difficulty and permanent memory loss.
"The patient may be left with some permanent memory loss of the time immediately before treatment," he says. "You will not forget your name, growing up, or getting married. But you may forget what happened at Thanksgiving. For example, when counseling patients getting ready to take a two-to-three week course of ECT on March 1, I'd tell them they might have difficulty learning new things for a few weeks. And they may have memory loss for early March, February, and January."
There are rare cases, McCall says, where patients say that ECT erased most of their memory. But if this really does occur, it's never been seen in a research study.