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Memory Loss Common Complaint With ECT

But Defenders Say Electroconvulsive Therapy Still the Best Option for Some Depression

From the WebMD Archives

June 19, 2003 -- Supporters say the controversial treatment called electroconvulsive therapy (ECT) helps severely depressed patients who have few other medical options, but new research concludes that this help may come at a high price.

One third of the surveyed patients who had ECT, better known as "shock therapy," reported persistent memory loss as a result. Many patients had very conflicted feelings about ECT, lead researcher Diana Rose, PhD, tells WebMD.

"There is no doubt that some people thought that ECT was very beneficial for them, but we found that this group was much smaller than the professionals think," Rose says.

Two years ago, the U.K.'s Department of Health (DOH) commissioned two reviews evaluating past studies of ECT.

The first report, made public in March, found electroconvulsive therapy to be an effective treatment for severely depressed patients who do not respond to drug treatments.

In the latest review, published in the June 21 issue of the British Medical Journal, Rose and colleagues compiled data from seven separate studies. At least one-third of patients complained of persistent memory loss after ECT.

Patients reported memory loss and dissatisfaction with electroconvulsive therapy more often in surveys conducted by consumer groups than in those conducted by their doctors.

Rose says patients may not feel comfortable complaining about electroconvulsive therapy to their doctors. This could explain why Britain's leading psychiatric organization recently reported a satisfaction rate of 80% among patients who had undergone the treatment, she says. The group also concluded that memory loss was not a significant problem in ECT patients.

"Our research suggests that persistent memory loss is a problem for a substantial proportion of patients, and that this loss can be quite profound," Rose says. "We heard from people who had gaps in their memory that included whole years. One person said it was like losing her identity, because your memories make up your identity."

Psychiatrist E. Fuller Torrey, MD, says electroconvulsive therapy is an important treatment option for severely depressed patients who do not respond to other treatments. It is an especially important option for depressed patients who are suicidal, he says, because the benefits are immediate. Torrey is executive director of the Stanley Medical Research Institute in Bethesda, Md.

"It doesn't work on everyone, but I have had patients tell me that it is the only treatment they want, because it is the only treatment that works for them," he says.

John Geddes, MD, who led the other DOH-commissioned review, tells WebMD that the two studies paint a more balanced picture of the benefits and risks of a highly controversial therapy.

"ECT is not just a treatment from our history, it is a treatment that has a place in psychiatry today," he says. "But this new research illustrates the importance of telling patients about the potential side effects and being scrupulous in obtaining proper consent."

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SOURCES: British Medical Journal, June 21, 2003. Diana Rose, PhD, senior research fellow; coordinator, Service Users Research Enterprise, Institute of Psychiatry, London. John Geddes, MD, professor of epidemiological psychiatry, department of psychiatry, University of Oxford, England. E. Fuller Torrey, MD, research psychiatrist, Stanley Medical Research Institute, Bethesda, Md.
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