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Electric shock treatment 'gives patients brain boost'

By Eilish O'Regan

Controversial electric shock treatment, which is still administered to depressed patients in Irish psychiatric hospitals, can significantly improve some brain functions, new research revealed yesterday.

The research, from Trinity College Dublin, comes against a background of an intense debate about the merits of the treatment that has included calls for its abolition by a number of former patients.

However, the research shows that the side-effects of electroconvulsive therapy (ECT), linked to memory and thought processes, are short-lived.

It added: "Moreover, for the vast majority of people these cognitive functions significantly improve beyond pre-treatment levels soon after completing a course of ECT."

The findings in the journal 'Biological Psychiatry' are based on research by Dr Maria Semkovska and Professor Declan McLoughlin, of the Department of Psychiatry and Trinity College Institute of Neuroscience.

Electric shock treatment is still given to about 500 people in Ireland every year and is administered to one million people worldwide. It is described as the "most powerful treatment available for depression" and was recently credited as a life-saver by 'Coronation Street' actress Beverly Callard, who plays barmaid Liz, after she suffered a breakdown.

The authors said modern electric shock treatment involved applying a small electrical charge to the brain of an anaesthetised patient under medically controlled, safe conditions.

"Repeated treatments induce several molecular and cellular changes in the brain that are believed to be important for its anti-depressant mechanism of action," the authors said.

The most common reason for the therapy is a patient's severe depression that has not responded to anti-depressant drugs and psychotherapy.

ECT could be a life-saving treatment for people with catatonia (people with severe depressive illness who are barely moving) and those who were actively suicidal or physically debilitated by depression, they added.

Prof McLoughlin said: "ECT is undoubtedly highly clinically effective but, unfortunately, its use has been limited by stigma as well as genuine public concerns about side-effects, especially on memory function.

"In our study we systematically reviewed all of the peer-reviewed scientific literature on ECT. We pooled data from more than 80 different studies, with nearly 3,000 patients.

"We then performed a series of global statistical tests, or meta-analyses, on 24 different standardised neuropsychology tests performed both before and after a course of ECT.

"While it was not possible to meta-analyse studies of retrograde memory function (ie the ability to recall previously learnt information), it was reassuring to establish that cognitive deficits associated with ECT are temporary and performance on most tests improve and are better than before ECT began.

"Our findings have immediate clinical relevance and will help people with severe depression, their families and clinicians to make better informed treatment decisions about ECT."

The patient support group MindFreedom Ireland has campaigned against the therapy, saying it leads to side-effects such as memory loss.

The Green Party introduced a bill in the Seanad last year aimed at banning its use on patients who have not consented to the treatment. The most up-to-date information from watchdog the Mental Heath Commission showed that in 2008, 407 Irish patients had ECT with their agreement.

But there were 43 patients treated who either were unable to consent or received it on the best advice of two specialists.

ECT is supported by doctors in the College of Psychiatry in Ireland, but they agree changes should be made in selecting doctors asked to give a second opinion as to whether it is right for a patient.

Belfast Telegraph


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