Today Search
Medical School Nurse Interviews

The shocking truth behind electroconvulsive therapy (ECT)

Hezne Ezaty Abu Hasan, 13 Jun 2017
Electroconvulsive therapy (ECT) is a form of treatment for mental disorders, where electrical currents are administered to a patient’s brain in small and safe quantities. This results in convulsions and seizures that change the brain’s chemistry, thus reversing certain mental illnesses.

ECT is considered to be among the quickest relief for suicidal and severely depressed patients. Apart from that, patients with mania, catatonia and whose symptoms have stopped responding to other forms of therapy could greatly benefit from ECT.

Practice traces back to 1938


ECT dates all the way back to the 1500s, where the original idea of curing mental illnesses through convulsions took place. Instead of being administered with electrical currents, patients were asked to orally consume camphor to induce the convulsions.

ECT with electrical rods as per the current practice only started in 1938 with an Italian psychiatrist and a neurologist, who induced a series of convulsions to successfully treat a catatonic patient.

Although ECT is generally safe, it has not overcome the side effects of bone breakage, joint dislocation and memory loss. Regardless, ECT was still used then as the other alternatives were lobotomy and insulin shock treatment.

Electroconvulsive therapy (ECT) machine used in 1945 through 1960. Photo credit: Science Museum, London
Electroconvulsive therapy (ECT) machine used in 1945 through 1960. Photo credit: Science Museum, London

ECT’s history continued through to 1950 when it was properly scientifically researched and prominently introduced a muscle relaxant called succinylcholine. It was administered together with anaesthesia to prevent patients from being injured and from feeling the ECT procedure.

A document outlining ECT procedures to prevent it from being abused and abusing patients was created in 1978, consistent with scientific findings.

Revisions to keep it current were done in the years 1990 and 2001. To date, the National Institute of Mental Health and the American Psychiatric Association have endorsed ECT’s use to treat specific conditions.

Controversies around ECT


During the 1950s, ECT was undoubtedly benefiting patients with mental illnesses. However, it was not without controversy as there was a lot of evidence indicating that ECT was forcefully used to control mental patients and to maintain order in the wards. Back then, ECT was administered in high currents and without anaesthesia, causing injuries and memory loss. This was the horrific scene that would be associated with ECT every time it was mentioned, thus preventing it from being of more benefit to others.

In the 1960s, the anti-psychiatry movement was born, where the very idea of mental illness was rejected and subsequently effecting ECT’s progress. It became the decline in ECT usage all throughout the 1960s and 1970s.

ECT’s usage picked up again in the 1980s with positive testimonials from well-known figures such as the late actress, Carrie Fisher who was suffering from mental illness.

ECT more efficient than drugs


Recent times have seen a study of 30 patients who were treated with ECT. The study showed that 80% of the patients would willingly repeat the procedure.

Out of the number, 70% found ECT useful and more efficient than drugs, such as fluoxetine, which acts as the physical fix for the illness and have been on the rise in modern times. ECT’s revolution with modern times to make it safe and standardised has helped to shake off the stigma of it being a terrifying treatment.

ECT has a high remission rate of 60 to 70% for patients who underwent the treatment. However, it also has a high relapse rate and patients have to be supplemented with medications such as prozac. In addition, ECT has yet to eliminate the side effects, particularly memory loss.

Though it is temporary, there are rare cases of long-term memory loss. Better understanding of ECT today such as the seizure quality and electrode placement allows for a more effective ECT.

Dr Latha Guruvaiah, lead author of the study said, "Many treatment options are available now for psychiatric disorders but still ECT is considered as an effective treatment and has been found to be potential lifesaver in many cases." MIMS

Read more:
Phineas Gage: The man who survived a fatal brain injury with all but his personality intact
6 horrifying and weird medieval medical practices
Understanding the molecular mechanism behind lithium in treating bipolar disorder

Sources:
https://www.scientificamerican.com/article/electroconvulsive-therapy-a-history-of-controversy-but-also-of-help/
https://www.sciencedaily.com/releases/2017/06/170605110046.htm
https://www.healthyplace.com/depression/ect/history-of-ect-how-the-ect-procedure-developed/
http://www.mayoclinic.org/tests-procedures/electroconvulsive-therapy/basics/definition/prc-20014161
http://www.webmd.com/depression/news/20030306/shock-therapy-still-here-still-used#1