Electroconvulsive therapy (ECT) previously known as electroshock therapy has been in practice for many years now, and was first introduced during the 1940’s by Dr. Cerletti and Dr. Lucio Ubini, Italian neuro-psychiatrists who derived it from the method of slaughtering pigs, before which they were electrocuted to unconsciousness. They found out, it was an effective way to ‘tame’ obsessive and troublesome mental patients. Use of substantial levels of insulin to shock patients into hour long comas also came under the category.
Unpleasant as it may sound, the treatment became widespread and psychotherapists added the process as one of their therapies which over the years has been made to be looked at as a useful treatment. The electroconvulsive therapy has now evolved to a brief application of electric stimulus used to produce generalized seizures through electrodes attached to the scalp. The treatment is advised to be used as a last resort for patients suffering from severe depression.
Because of its disagreeable nature, the treatment has been a controversy and an issue still debated on among the medical community. This is one of the reasons why informed consent of the patient has become a vital requirement for the treatment. Informed consent is considered vital as memory loss is one of the several side effects.
The controversial therapy has been in debate ever since its use became common. The predicament is whether it should be used as a ‘last resort’ or as a preliminary intervention. In the book, “The Practice of Electroconvulsive Therapy, Second Edition”, a task force report by the American Psychiatric Association, it is said that the use of ECT is more effective if used as a primary intervention as it may bring better results due to the prompt use of the therapy, however, patient consent and their general health condition should be taken into consideration.
On the other hand, In a research based study about the issue by National Institute for Health and Clinical Excellence (NICE), ECT has shown fast and short term improvements in people having severe symptoms of depression. But this therapy should be the last resort for patients who have failed to respond to all other kinds of treatments or when the situation is life threatening. About 50% of depressed people who do not improve through antidepressant medication and other forms of therapies have showed signs of improvement with ECT.
When Electroconvulsive therapy (ECT) should be used:
• When medication fails to respond
• When antidepressants have side effects
• When the patient has a life threatening condition
• When no other psychotherapy is making improvement
• When the patient have gone through ECT in the past and it has helped
• When the patient is ready for it with their own consent
It is also important to keep in mind the responses of the individuals who undergo this treatment. In a paper by Anne Donahue, “A Basic Layperson’s Guide to Decision making about ECT”, thorough research about the success of the therapy and its side effects are discussed in detail since she is a former patient who went through ECT, and in her research she informs that ECT as a primary intervention however useful it may be in the short term, the relapse time lasts maximum up till 6 months and getting the treatment done again and again is not a very healthy option and has numerous negative effects.
Considering both sides of the story, I believe, the choice of going for an Electroconvulsive Therapy should depend entirely on the patient suffering from the mental illness since only they’d best understand the need for such a treatment and how necessary it is for them. After much research about the method of treatment and its process, ECT should only be used as a last resort of treatment and the patient should be made aware of the side effects of the treatment when given the option. Furthermore, the equipment, machinery and the doctors should be experts on the field before starting treatment on any of their patients.
References:
American Psychiatric Association. (2001). The Practise of Electroconvulsive Therapy: Recommendation for Treatment, Training & Privileging. Washington, DC: American Psychiatric Publishing.Inc.
Barnes, R. (2011, July). The Royal College of Psychiatists. Retrieved from RcPsych: http://www.rcpsych.ac.uk/mentalhealthinfoforall/treatments/ect.aspx
Donahue, A. (2007, Feburary). Timesargus. Retrieved from http://www.timesargus.com/assets/pdf/BT345701212.PDF
Technology appraisals TA59. (2003, Apirl). National Institute for Health & Clinical Excellence. Retrieved from http://www.nice.org.uk/TA059
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