A call to action . . .

The four paragraphs allotted to ECT in the draft of the Surgeon General's Report (SGR) on Mental Health misrepresent this very controversial procedure as "safe and effective." In reality, it is neither.

The Report cites one main source - Weiner & Krystal, 1994 - six times in the report; and only five other sources are cited. Clearly, the Surgeon General's Office simply did not do its homework, since there is a vast quantity of material that indicates that ECT is not safe. Nor is it effective, since all agree that any benefits - a lifting of depression - are short-term.

It is important to note that the "Weiner" cited so frequently in the Report is "Richard Weiner, head of the American Psychiatric Association's task force on ECT, and also the head of the task force or committee which petitioned the FDA to reclassify the shock machine from Class III to Class II back in l982, and [has] spearheaded that unsuccessful attempt up until the present," writes Linda Andre, head of the Committee for Truth in Psychiatry, the national organization of shock survivors.

Andre continues: "Doug Cameron's book names Weiner as the central figure in one of the greatest frauds perpetrated on the American public, 'The Great Electroshock Hoax' (title of book), in which machines were designed to be ever more powerful while the public was being told they used 'less electricity.'

"As a paid 'consultant' to shock machine companies, Weiner] designs virtually all of the shock machines in the United States, and thus is responsible for upping the electricity on each new generation of shock machines. . . . He admits getting $$ from shock machine companies but says it's deposited in his 'research' account. [He] won't say how much. Shock machine companies thank him in their instruction annuals. Krystal is simply his young protégé."

If you are outraged by this whitewash of an extremely dangerous and controversial procedure, write David Satcher, M.D., Ph.D., U.S. Surgeon General, 200 Independence Avenue, S.W., Washington, D.C. 20201, Phone: 202-690-7694, Fax: 202-690-6960.

Below are some of the assertions made by the Surgeon General's Report, followed by the reality:

SGR: "ECT is regarded as a safe and effective treatment for depression . . ." (Weiner & Krystal, 1994).

Reality: ECT is an extremely controversial procedure, which is certainly not safe. It has resulted in death, and always results in memory loss. It may also damage cognitive abilities. Consider some of the dangers:

• Death. For example: In a study of 3,288 people who received ECT in Monroe County, New York, ECT recipients were found to have an increased death rate from all causes (Babigian, H., et al., "Epidemiologic Considerations in ECT," Arch Gen Psych 1984; 41:246-253). -- Brown University researchers evaluated survival rates in 65 patients who had been hospitalized and treated for depression. According to their report, the 37 patients who had ECT had survival rates of 73 percent at one year, 54.1 percent at two years, and 51.4 percent at three years. This contrasts with people who were depressed who did not receive ECT; their survival rates were 96.4 percent, 90.5 percent and 75 percent at one, two and three years, respectively. (Kroessler & Fogel, "Electroconvulsive Therapy for Major Depression in the Oldest Old," Am J of Geriatric Psychiatry 1993; 1:1:30-37). In Texas, the only state that keeps such records, the first three years of mandated recording of death within two weeks of ECT yielded reports of 21 deaths (11 cardiovascular, three respiratory, and six suicides (Don Gilbert, Commissioner, Texas Department of Mental Health and Mental Retardation, 1996). (A 1995 report in USA Today noted that a 1993 study of elderly ECT recipients in Texas found that 27 percent of them were dead within a year, compared to 4 percent of a similar group who had been treated with medication.)

• Cardiovascular problems. For example: The seizures induced by ECT cause a quick rise in blood pressure, while the brain experiences a significant reduction in blood flow (Webb, et al., "Cardiovascular response to unilateral ECT," Biol Psych 1990; 28:758-766. Rosenberg, et al., "Effects of ECT on cerebral blood flow," Convulsive Therapy 1988; 4:62-73). -- The Mayo Clinic found that there was an 18 percent incidence of serious heart arrhythmias during treatment of 34 elderly people receiving ECT. The same study found that 79 percent of these individuals suffered treatment complications (Tomac and Rummans, "Safety and Efficacy of Electroconvulsive Therapy in Patients Over Age 85," Am J Geriatr Psy 1997; 5:126-130). -- Eleven percent of 87 elderly people receiving ECT "remained delirious between ECT sessions for no discernible medical reason other than the ECT itself." MRIs of these people showed that 90 percent of them had lesions in the basal ganglia areas of the brain, and 90 percent also had moderate to severe white matter lesions (Figiel, Coffey, et al., "Brain MRI findings in ECT-induced delirium," J of Neuropsych and Clin Sci 1990; 2:53-58).

• Epilepsy. For example: Researchers who reviewed the literature on the ECT complication of epilepsy calculated that "the age-adjusted incidence of new seizures after ECT was fivefold greater than the incidence found in the non-psychiatric population" (Devinsky & Duchowny, "Seizures after convulsive therapy: A retrospective case survey," Neurology 1983; 33:921-5). See also Weiner, RD, "Prolonged confusional states and EEG seizure activity following ECT and lithium use," Am Journal Psych 1980; 137:1452-1453, and Varma, NK et al., "Nonconvulsive status epilepticus following ECT" Neurology 1992; 42:2263-264).

• Memory loss. For example: 'Data available from the California Department of Mental Health reveals that more than 99 percent of ECT recipients report memory loss three months following treatment, with the average number of ECT sessions being five or six (A. Lazarow, Chief, Office of Human Rights, California Department of Mental Health, 1996).' "Many cases involve losses that prohibit a return to normal activities in the home or at work. Indeed, there are repeated warnings in the literature against giving ECT to individuals who earn their living through mentally taxing work" (Breggin P.R., "Neuropathology and Cognitive Dysfunction From ECT," Psychopharmacology Bulletin 1986; 22:2, 476-482. Valentine M, Keddie HMG, Dunne D, "A comparison of techniques in electroconvulsive therapy," Br J Psychiatry 1968; 114:988-96).