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Page 4 of 5
Of the roughly 150 people who responded to ECT, only about 25 (we don't know the exact number because Sackeim says different things in different places) were free of depression six months after shock. An equal number, about 21, had become so depressed again that they had more shock within six months. That's a total of only about 10% of the total who had any benefit from shock that lasted as long as six months.
The study notes that most patients who relapsed did so very quickly. This is consistent with earlier studies. NIMH reviewed these studies and concluded that there is no scientific evidence that any benefit of ECT lasts longer than four weeks.
It has been noted by numerous scientists that this extremely brief period of well being is entirely consistent what is seen in other types of brain injuries, and with the theory that ECT "works" by causing an acute organic brain syndrome.
In contrast to benefits, the adverse effects of ECT are permanent. At any length of time at which survivors have been followed up post-ECT, the vast majority report a stable retrograde amnesia for months or years. When survivors have been tested with instruments sensitive to brain injury at any length of time post-ECT, they have exhibited stable and permanent deficits in intelligence, memory ability, abstract thinking and other cognitive functions, and the pattern of impairment is consistent among survivors no matter when or where they had ECT. All of the adverse effect reports collected by the FDA are of permanent, enduring deficits. The effects of electricity on the human brain have not been mitigated by any claimed improvements or refinements by the industry. There is a great deal of variance among individual ECT patients, because the amount of electricity received varies greatly and cannot be controlled by even the most modern devices, due to human physiology and the nature of electricity. There is no way to predict who will be most devastated by ECT.
ECT's morbidity rate is 100%. It commonly results in permanent disability, and lifetime Social Security payments, in adults who previously were able to work. Its mortality rate, based on very spotty statistics, may be as high as 1 in 200. ECT has not been shown to be more effective than no treatment at all, and even the most biased estimate of its longterm efficacy rate is only 10 to 40%.
You would be right if you guessed that the FDA has placed the ECT device in its Class III, High Risk category. FDA warns that the benefits of ECT do not outweigh its risks and that its risks include brain damage and memory loss.
If ECT were a drug just coming on to the market, it would not be allowed to be used.
If safety trials of a drug showed that the drug caused permanent amnesia, disability, and brain damage in even a small fraction of those who have experienced these effects due to ECT, that drug would be pulled off the market.
Would it surprise you at this point to learn that there have never been any safety trials of the ECT device? There have not. None of the manufacturers of the devices have ever conducted a single safety test. (When manufacturers, in their ads, say their devices are safe, they mean safe for the treating psychiatrists and nurses!) Even in 1997, when the FDA belatedly called for them to submit safety information, they did not submit one shred of evidence, because there is none. They knew there would be no consequences for not submitting the required information, and there have been none. If the ECT device didn't have the powerful lobby of the American Psychiatric Association behind it, it would be pulled off the market.
You may rightly ask why ECT continues to be used given its terrible track record. There are many reasons. One is the historical quirk that ECT was invented in fascist Italy, at a time and place where there were no protections for patients and no regulation of industry, that it continued to be used free of the restrictions and protections we take for granted in this country, and that today it is still largely immune from such restrictions and protections. We can't even get the most basic information about the use of ECT in New York State today, such as how much it's done!
In 1976 the APA formed its Task Force on ECT, and since then ECT has been kept alive largely by vigorous sustained effort on the part of a dozen men who design the machines, conduct the research, consult for the companies, and otherwise owe their highly paid lifestyles to ECT. New York State is home to two men in particular who have staked everything on ECT and have everything to lose if it is discredited. It's the shame of our state and part of the reason all attempts at patient protection here have failed so far. Both men are or were state employees. No wonder OMH is so invested in the forced shock of Paul Thomas, Adam Szyszko, and so many others.
Fink and Sackeim and a few others around the country are so busy promoting ECT, lying to the media, conducting big ticket how-to-do-shock seminars, etc., because if they let up on their public relations campaign for a minute ECT would collapse under the weight of all the scientific evidence against it.
Did I mention how enormously profitable it is? Medical journals recommend setting up "ECT suites" to bolster incomes threatened by managed care. Insurance companies pay for ECT without asking questions, and that's not an accident; the proponents of ECT, such as Dr. Fink, are consultants to the insurance companies. Psychiatrists who do ECT make an average of twice the income of those who don't use it, and they can achieve this increase in income by working only the few hours a week it takes to give a bunch of treatments. It's easy to set up an ECT practice; all you have to do is pay about a thousand dollars to Drs. Fink, Sackeim, Weiner, etc.; go to the seminar for a few hours, pass the test and you're considered qualified to do ECT. This practice bears further scrutiny by the Assembly.
As a society, we allow things to be done to mental patients that would be unconscionable if done to persons without psychiatric labels. Hatred and fear of mental patients is so ingrained among the general population, and so unquestioned, it's never recognized for what it is, except by those of us who are on the receiving end of it every day. Getting a psychiatric label is like having a curse placed on you: from this day on, as long as you live, you will not be believed. You may dismiss my testimony and that of my peers, if you wish, as the ravings of an irrational crazy person, without compunction, because it's socially acceptable for you to do so. You may place less value on the brain and life of Paul Henri Thomas than you would on your own, and that again is socially acceptable. You may even do these things without conscious awareness that you are doing them. This is how shock and forced shock came to be, and how they continue.
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