Most articles about electroconvulsive therapy (ECT), whether in newspapers and magazines or academic journals, describe the treatment as “safe and effective” often adding something about how it “can be life-saving”, even if the contents of the article don’t actually support these claims being perhaps some research which casts doubt on its safety and effectiveness (although safe and effective are elastic terms which can be stretched to mean anything you want them to) or an interview with someone whose experience with the treatment wasn’t that impressive.
The current issue of the Skeptic magazine contains an article by American psychologist Bruce E. Levine called “Depression treatment: what works and how we know”. You can read the text of the article here. Much of the article is about antidepressants and how they compare to placebos (with some interesting comments on the manipulation and misquoting of research) but there is a short section about ECT which includes:
“Andrew Solomon in The Noonday Demon also states, “ECT seems to have some significant impact between 75 and 90% of the time. About half of those who have improved on ECT still feel good a year after treatment.”10 Is ECT really that effective?
In 2004, medical researcher Joan Prudic and her team at New York State Psychiatric Institute conducted a major study of ECT involving 347 patients at seven hospitals. Reported were both the immediate outcomes and the outcomes over a 24-week followup period. With respect to immediate outcomes, Prudic reported: “In contrast to the 70 to 90% remission rates expected with ECT, remission rates, depending on criteria, were 30.3 to 46.7%.” Even worse for ECT advocates, Prudic noted that, “10 days after ECT, patients had lost 40% of the improvement.” (Prudic, J., et at. 2004. “Effectiveness of Electroconvulsive Therapy in Community Settings,” Biological Psychiatry, 55(3):301-12.)”
The author goes on to say how a number of studies which compared sham ECT (that is, the treatment without the actual electric shock) with real ECT found that the difference between the two was only modest and not long-lasting.
These are useful comments but what is perhaps more interesting than the comments themselves is the history of the publication of the article, which the author explains here. Originally the article was intended for the Huffington Post, but the Huffington Post editor wanted to insert a note saying:
“ECT is now a safe, life-saving treatment for people with psychotic depression or severe, suicidal depression that does not respond to a systematic approach that combines medication and therapy.”
This was unacceptable to the author and so the article was not published in the Huffington Post.