Debate Rages Over Safety of ECT, or Shock Therapy, Used on Elderly - ECT Related to Memory Problems

Written by Tom Lyons

Health Canada, like the FDA, has never conducted medical safety tests of ECT machines, nor has it required the ECT machine companies themselves to submit safety and effectiveness data.

"No performance and maintenance standards exist for ECT machines. The Bureau of Medical Devices has not tested ECT machines since there have not been any reported problems. The bureau has never inspected shock machines," wrote Dr. A.J. Liston, then assistant deputy minister of health, in a Feb. 4, 1986 response to questions raised by Weitz.

Health Canada spokesman Ryan Baker says there are no plans to conduct a medical safety investigation of the only ECT machine currently licensed for sale in Canada, the Somatics Thymatron, which was "grandfathered" into use without the submission of safety and effectiveness data sometime prior to 1998, when the current medical devices regulations were enacted.

"A lot of these questions come down to the practice of medicine, like the use of these devices. And Health Canada doesn't regulate that. We regulate the sales," says Baker.

In early years of ECT, most doctors didn't use it on seniors. Most doctors disapproved of the use of electroshock therapy on the elderly during the first era of the treatment, which began in 1940, when the "miracle cure" for mental disease was imported to America from Italy by Dr. David Impastato.

That so-called first era lasted until the late 1950s, when the treatment, also known as ECT, began to be supplanted by the new psychiatric drugs.

Impastato warned psychiatrists in 1940 not to shock patients over the age of 60, and his advice was generally heeded.

"The majority of physicians continue to be opposed to the application of electric convulsive therapy during the senium (sixty years and over)," reported Dr. Alfred Gallinek, a New York psychiatrist, in 1947.

An adventurous minority ignored Impastato's advice, however, with sometimes catastrophic results. In a 1957 survey, Impastato found that electroshock recipients over the age of 60 had a 15 to 40 times higher ECT fatality rate than younger patients (0.5 per cent to one per cent as opposed to 0.025 per cent to 0.033 per cent).

In Canada, where ECT was introduced in 1941, a similar split occurred.

Dr. A.L. Mackinnon, of The Homewood Sanitarium in Guelph, Ont., noted in 1948 that seniors comprised only seven per cent of his institution's electroshock recipients. Dr. John J. Geoghegan, of the Ontario Hospital at London, Ont., on the other hand, reported electroshocking seniors regularly with "excellent" results in 1947.

Still others tried it and regretted it.

"Shock therapy is dangerous therapy," warned Dr. Lorne Proctor, a Toronto psychiatrist, in 1945, after a 65-year-old man suffered a paralysing stroke from electroshock.

"The possibility of cerebral hemorrhage following stimulation of the frontal lobes by this technique is real."

Similarly, Dr. G.W. Fitzgerald, of the Regina General Hospital, reported the death of a 59-year-old farmer from ECT in 1948.

Dr. George Sisler, of the Winnipeg Psychopathic Hospital, reported the electroshock deaths of a 50-year-old farmer in 1949 and a 60-year-old office worker in 1952.

next: ECT and Brain Damage
~ depression library articles
~ all articles on depression