Two weeks ago Manchester University put out a press release about their study on electroconvulsive therapy (ECT) and ketamine, for which they are just starting to recruit patients.
The researchers, who have received a grant of over a million pounds, are led by Professor Ian Muir Anderson. They are hoping to establish that ketamine, when added to the anaesthetic during ECT, will both reduce the adverse effects of ECT and increase its effectiveness. This would be a first, because usually strategies which decrease the adverse effects of ECT also decrease the desired effects.
The press release says:
“It is particularly hoped that ketamine will reduce the longer-term loss of past memories, including autobiographical memory – which may include memories of childhood holidays, growing up and early life – that some people experience with ECT and which can be very distressing.”
This is a very strange description of the memory loss associated with ECT. Generally, the memories lost are those for things that happened in the years immediately before ECT, not more distant memories. You are more likely to lose the memory of last year’s holiday, rather than a childhood one.
It’s a pity the million pounds didn’t cover the cost of the researchers doing a little background reading on the subject and getting straight what sort of memory loss they are dealing with.
The researchers are hoping to recruit 160 patients from five mental health trusts: Manchester Mental Health & Social Care Trust, Northumberland, Tyne & Wear NHS Foundation Trust, Leeds & York Partnership NHS Foundation Trust, Greater Manchester West Mental Health NHS Foundation Trust and Pennine Care NHS Foundation Trust. I wonder how easy it will be to recruit those patients. After all, patient information leaflets about ECT generally describe the memory loss in reassuring terms (mild, temporary, etc) so people must justifiably ask “why bother with ketamine then?” I was curious to see what the participating trusts tell patients about ECT-induced memory loss, but could find only one on-line patient information leaflet, that of the Northumberland, Tyne & Wear NHS Foundation Trust. The leaflet says:
“Some patients may be confused just after they wake up from the treatment and this generally clears up within an hour or so. Your memory of recent events may be upset and dates, names of friends, addresses and telephone numbers may be temporarily forgotten. In most cases this memory loss goes away within a few days or weeks. Occasionally some people continue to experience memory problems for several months. Research studies have suggested that a number of people believe they have suffered long-term memory problems as a result of ECT.”
Typically, it allows for only fairly minor and transient effects – at most involving, and even then only occasionally, “problems” lasting several months. Anything longer-term is only a “belief”.
Pennine Care NHS Foundation Trust meanwhile has a “jargon buster” which says:
“The most common risks associated with ECT are disturbances in heart rhythm. Broken or dislocated bones occur very rarely.”
No mention at all of memory loss.