Research in psychiatry clearly demonstrates that ECT is far from "safe and effective" - a phrase improperly applied as ECT, unlike a vaccine, carries no requirement that safety and efficacy is proven. Paternalistic dictum, not rational scientific basis, establishes ECT as a medical treatment; the real reason ECT is given is because doctors think it should be. All areas are controversial - knowledge lacunae psychiatry actively encourages. Clinical indications - to say nothing of a considerable non-clinical component - contra-indications, therapeutic aim and agent, the necessity (or otherwise) for a convulsion, method of application, mode of action, stimulus dose, side-effects, efficacy, consent... and so on, are each disputed by clinicians. Bar two from newspapers, the following quotations by mainly pro-ECT authors are taken from the professional journals and books. They're damning,  yet won't damn, for psychiatry has imbued ECT with shape-changing properties.

Do you realise that ECT has been linked with brain atrophy?

"A history of electroshock therapy (EST) is associated with larger ventricles. The 16 patients who had received EST had larger ventricles than the 57 patients who had not." (Weinberger et al., 'Lateral Cerebral Ventricular Enlargement in Chronic Schizophrenia, Arch. Gen. Psychiat., Vol. 36, July 1979)

"Among the subset of patients who had received electroconvulsive therapy in the past, a significant correlation was observed between number of electroconvulsive treatments and lateral ventricle volume." (Andreason et al, 'Magnetic Resonance Imaging of the Brain in Schizophrenia: The Pathophysiologic Significance of Structural Abnormalities,' Arch. Gen. Psychiat., Vol. 47, January 1990)

Pro-ECT psychiatrists rely heavily on the absence of uniform scan evidence of damage to insist that ECT doesn't cause brain damage. ECT affects people in different ways, apart from which it is the abnormal brainwave patterns, indicative of epilepsy, that offer vital clues. Hughlings Jackson proposed that the understanding of epilepsy was the key to insanity. It is certainly an important key to somatic, mental and personality degeneration CAUSED by ECT - as epilepsy, with or without clinical seizures, provides a physical mechanism by which many of the diseases of ECT are explicable.

"[Psychiatric] patients with a wide variety of episodic behavioural disturbances ranging from depersonalisation, free floating anxiety, depression to impulsive behaviour, destructive rages, and catatonic-like states show abnormal EEG activity in temporal lobes... Patients with EEG abnormality of temporal lobes... show an unusually high incidence of personality disorder." (Slater, Beard and Glithero, 'Schizophrenia-like Psychoses of Epilepsy,' International J. Psychiat., Vol. 1, 1965)

It isn't disputed that epilepsy can occur as a result of ECT:

"...Small and associates reported the occurrence of a right temporal lobe epileptic focus in a patient receiving a combination of lithium and right unilateral nondominant ECT." (Weiner et al.,'Prolonged Confusional State and EEG Seizure Activity Following Concurrent ECT and Lithium Use,' Am. J. Psychiat., 1980)

Psychiatrists say that, following the introduction of anaesthesia, ECT creates epilepsy only rarely - but is this entirely accurate?

"The term status epilepticus (SE) denotes protracted or repetitive seizures that result in a "fixed epileptic condition." Typically, SE occurs in two primary clinical forms -  convulsive and nonconvulsive. ... Nonconvulsive SE is often more difficult to detect clinically and is either absence (petit mal) or partial complex (temporal lobe) in nature. A recent study found a high incidence of patients with psychiatric disorders...among those who have nonconvulsive SE. This type of SE often requires an EEG to confirm the diagnosis." (Daniel J. Lacey, 'Status Epilepticus in Children and Adults,' J. Clin. Psychiat. 49:12 (Suppl), 1988)

Although an EEG is NOT administered by way of a routine check prior to ECT, interestingly, where it is:

"Our patient had been healthy and the EEG prior to the ECT was normal. We presume that this disorder [epilepsy] was caused by a lesion in the brain-stem caused by the ECT." ('Electroencephalography and Clinical Neurophysiology,' 23, p. 195, 1967)

Attribution of alleged seizure disorder disappearance to anaesthetic modifications of convulsive treatment might mislead:

"Our study...does not indicate that modern ECT has eliminated iatrogenic epileptogenesis. Seizures may actually be significantly underreported in the recent literature. (Devinsky and Duchowny, 'Seizures after convulsive therapy: A retrospective case study,' Neurology 33, 1983)

The undoubted similarities between epilepsy and ECT should be remarked. With epilepsy proposed as the key to insanity, it goes without saying that researchers in psychiatry and neurology have been keen to study the connections between spontaneous and induced fits.

"When first introduced it was hoped that it [ECT] would throw some light on epilepsy, with which its convulsive effect is related, but beyond the confirmation of certain therapeutic aspects of epilepsy...it has not yet brought any major revelation such as those obtained by non-clinical techniques. It is essential, however, that research should continue to follow this..." (W. Grey Walter, 'The Living Brain,' Penguin, 1961)

"The need to determine the distinct and precise cut-off point of convulsive activity...does raise a number of questions about the basic physiology of convulsive seizures. The mechanism which would provide such a precise endpoint to electroencephalographic grand mal convulsive activity is not known at this time.... We feel that this phenomenon alone warrants further investigation. Perhaps this technique [Multiple Monitored Electroconvulsive Treatment]...could...provide an opportunity for study by a variety of investigators since the EEG activity can be recorded and since the convulsive activity is predictably produced as a part of the clinical treatment of the psychiatrically ill patient." (White, Shea and Jonas, 'Multiple Monitored Electroconvulsive Treatment,' Am. J. Psychiat. 125:5, 1968)

"ECT is part of the history of epileptic studies, and its understanding and that of epilepsy march together." (John C. Cranmer (Institute of Psychiatry), 'The Truth About ECT,' Brit. J. Psychiat. (1988), 153 (Correspondence))