NCPA - National Center for Policy Analysis

Electro- convulsive Therapy: Controversial But Effective

February 2, 2001

Many years ago electroconvulsive therapy (ECT) -- the psychiatric use of an electric current to stimulate a grand mal (epileptic) seizure -- earned the reputation of being savage. ECT patients used to suffer excruciating muscular convulsions, bitten tongues and broken bones or serious spinal injuries.

However, it was the first effective treatment for otherwise untreatable conditions that are now known to be organic brain disorders, such as psychotic depression, schizophrenia and catatonia.

Although widely used after its development in the 1930s, by 1980 less than 3 percent of all psychiatric in-patients were being treated with the procedure.

Today, patients are given anesthesia and are unconscious during the treatment; the convulsive effects are barely noticeable.

After almost being outlawed, ECT is experiencing a comeback, say observers, although doctors still don't know why it works.

  • A 1993 commentary in the New England Journal of Medicine stated, "Electroconvulsive therapy is more firmly established than ever as an important method of treating certain forms of depression."
  • The first phase of a National Institute of Mental Health-supported study, to be published this spring, found that ECT produced a greater than 95 percent remission rate in psychotically depressed patients -- vastly higher than for any drug on the market.

Today, about 100,000 patients each year are treated with ECT -- nearly triple the number in 1980. But the therapy is unavailable at most publicly funded institutions, due to public perceptions, opposition from some dissenting psychiatrists and Scientology groups opposed to coerced psychiatric therapy.

Source: Daniel Smith, "Shock and Disbelief," Atlantic Monthly, February 2001.

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