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New Light on ECT© John McManamy
"For the first time, your choice can be an informed one."
The Achilles heel in the psychiatric profession's selling ECT to the public has always been the fact that the benefits of ECT are not long lasting, which necessitates continuation ECT (routine follow-up ECTs on a regular basis), about which we know very little. Now we know a little bit more, thanks to a Brown University study recently published in the American Journal of Psychiatry. The patient sample, though relatively small, represents the largest study to date in this area, and the findings demand our undivided attention, whatever one's views on ECT happen to be. All the patients in the study - in their sixties, most with depression, some with bipolar - had received an initial course of ECT of between four and 15 treatments, usually two or three treatments a week. Twenty-nine patients were assigned continuation ECT (with their medications) and tracked over a 5.4-year average period. The other 29 were treated with antidepressants and mood stabilizers alone, and observed over an average period of 2.4 years. For continuation ECT, patients in general were treated weekly for the first month, every two weeks for the following month, and then monthly. What the study found was that the chance of surviving without a relapse over a a two-year period was 93 percent in the continuation ECT group vs 52 percent for the antidepressant-alone group. Over five years, the survival rate dropped to 73 percent for continuation ECT patients, but plummeted to 18 percent for the antidepressant-alone group. At around six and seven years, the survival rate dropped sharply for the ECT group but still remained higher than the antidepressant-alone group. The mean time of relapse or recurrence was 6.9 years for those on continuation ECT compared to 2.7 years in the antidepressant-alone group. The lead author of the study, Lawrence Price MD, informed this writer that the study was not funded by any ECT machine manufacturer, nor was there any conflict of interest. The study does not shed any light on the long-term effects of continuation ECT, whether it is safe or whether there is a risk of harm, so if you have reservations about getting ECT that fear is not likely to go away. But now - thanks to this study - you can weigh that fear against your other big concern: that of relapsing into another killer depression. It will always remain a hard choice, but now, possibly for the first time, your choice can be an informed one.
The copyright of the article New Light on ECT in Depression is owned by John McManamy. Permission to republish New Light on ECT in print or online must be granted by the author in writing.
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