ECT Anonymous - Research Information - May 1999 - ECT is Far From Safe and Effective

Written by Juli Lawrence

"In the five years since two of us described intensified electroconvulsant therapy (Page and Russell 1948) we have treated more than 3500 further cases involving more than 15,000 treatments. Many critics seem to have a wrong conception of the method, and believe that the patient receives ten separate treatments in one day. We therefore emphasise that the course normally consists of one treatment daily, and is not given twice a day except in the severest cases. The method originally consisted in giving an initial stimulus of 150V for one second. This stimulus was immediately followed by seven further stimuli of one second each at 150V at intervals of half a second. The number of extra stimuli was increased by one at subsequent daily treatments, up to ten on the fourth day. More recently we have increased the number of extra stimuli, and aim to give sufficient in each case to maintain the tonic phase long enough to take the place of, and eliminate, the clonic phase of the fit. The number required varies with different patients, and is usually between eight and fifteen. The lower number is sufficient in an elderly patient, whereas a young schizophrenic may require fifteen or more. The elimination of the clonic phase may also be achieved with a continuous stimulus of from ten to fifteen seconds." (R. J. Russell, L. G. M. Page & R. L. Jillett, 'Intensified Electroconvulsant Therapy,' The Lancet, 5.12.'53)

"The general conclusion from this survey...is that irreversible sequelae of electrically provoked convulsions are infrequent.... Their occasional occurrence cannot be denied, however, particularly if the number of electric shocks had been very large or shocks had been given (as is done in the so-called intensive treatment) in rapid succession, thus approximating to the events of status epilepticus which is well known to cause more severe sequelae than single seizures. Since frequency and intensity were both marked in our two cases the occurrence of a mild marginal gliosis and patchy astrocytosis of the white matter should not cause surprise. This view is in complete agreement with that of Scholz (1951) who saw no reason why electrically induced convulsions, particularly if they were frequent, should not cause the same type of histological sequelae as is observed after spontaneous epileptic convulsions." (J. A. N. Corsellis and A Meyer, 'Histological Changes in the Brain After Uncomplicated Electro-Convulsant Treatment,' J. Ment. Sci. (1954), 100)

Increases in frequency could also be achieved by giving several convulsions per day over several days, a variation of ECT known as "Regressive." It leaves the person helpless, confused, apathetic, mute, incontinent and unable to eat without assistance.

"Regressive" electroplexy had no lasting beneficial effect on eighteen schizophrenic cases treated. ... This form of physical treatment is not only difficult to carry out, but also involves considerable risks. In the light of our experiences we have discontinued the use of "regressive" electroplexy." (Paul L. Weil, '"Regressive" Electroplexy in Schizophrenics,' J. Ment. Sci. (1950), 96)

Despite lack of verification for the effectiveness of variants of conventional ECT involving increases in the temporal frequency of treatments, it remains available as 'Multiple Monitored Electroconvulsive Therapy' (MMECT).

"Despite the fact that prolonged seizures represent a potential risk for the development of neurologic sequelae and are not associated with increased therapeutic benefits, this phenomenon has not been adequately dealt with in the psychiatric literature, and many practitioners are not aware of its significance, detection, and management. ...
In the more recent technique of multiple monitored ECT, in which two or more EEG-monitored seizures are evoked during a single period of anesthesia, prolonged seizures occur on a much more frequent basis, lasting as long as an hour" (Weiner, Volow, Gianturco and Cavenar, 'Seizures Terminable and Interminable with ECT,' Am. J. Psychiat. 137:11, 1980)

It is surely necessary to wonder what anyone ever was or is doing utilising techniques of ECT in such a way as to induce the brain rhythm of pathological states linked to disequilibrium, through creating a breakdown of the controlling mechanisms of homeostasis normally so carefully preserved by the autonomic nervous system, especially given the supposed mental illnesses that ECT supposedly treats are NOT accompanied by changes in the EEG

"...in what may be called "the problems of function" provided by the main psychiatric reactions...and in relation to individual differences of temperament, intelligence and personality, in all these the EEG has so far proved of little value." (Denis Hill, 'The Relationship of Electroencephalography to Psychiatry,' J. Ment. Sci. (91), 1945)

"Occasionally disorders of thought are found associated with wildly exaggerated alpha characteristics, but mental illness is usually accompanied only by the most subtle and evanescent changes in the EEG." (W. Grey Walter, 'The Living Brain,' Penguin, 1961)

Make no mistake, it is ECT that causes abnormal alterations in the EEG associated with pathological ductility, compromised homeostatic functioning and epilepsy and, through induced epileptogenesis, with behavioural and personality disorders. Clearly, the EEG plays a pivotal role in any exploration of ECT.

"...slow delta rhythms are rarely recorded in normal, awake adults. The do appear, however, in various pathological states and are interpreted as evidence of pathology. ... EEG studies spanning a 28 year period show that ECT alters brain physiology from normal to abnormal. These changes, principally a slowing of the EEG waves, are similar to those found in epilepsy, mental deficiency, and other neuropathologies. The EEG changes associated with ECT appear to be extremely long-lasting; very possibly they are permanent. They do not tell us whether a patient has lost his memory, for that you have to ask the patient. They do tell us that ECT can cause profound alterations in brain function." (Prof. Peter Sterling (Neurobiology), in his testimony for the Standing Committee on Mental Health of the Assembly of the State of New York, 5.10.'78)

"There are now [in 1970] available over twenty studies of the effects of unilateral ECT.... Of these, a few have looked at subsequent EEG records, and most have found evidence of electrical disturbance (e.g. slow waves) ipsilateral to the side of electrode placement." (James Inglis, 'Shock, Surgery and Cerebral Asymmetry,' Brit. J. Psychiat. (1970), 117)