"This is what happens when you ask patients what they think," said patient turned prominent ECT critic Linda Andre, who has questioned ECT research and practice. "You get a completely different story from the one psychiatrists are telling."
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Weighing benefits, risks
Dr. LOREN MOSHER, former director of schizophrenia research at the National Institute of Mental Health and now a clinical professor of psychiatry at UC San Diego, said the issue comes down to a "cost-benefit" analysis. "Does it make sense to expose people to something which not only isn't very effective but also has serious inherent danger? In my view, the cost to the person is greater than the potential benefit."
Until doctors find an answer for severe depression whose costs are not so steep, the controversy is not likely to diminish. Drug companies have been working to find better antidepressants for years, so far without significantly improving on what's been available for the last 10 years or so. Now, Lisanby and other researchers are investigating the possibility of using magnetically induced convulsions as an alternative to electricity. A strong magnetic field near the head can also induce a brief seizure. The hope is that the magnetic stimulation might "break" the depression in the same way ECT does, but for longer than a few months or weeks and without the memory loss.
"ECT is an important treatment, and has helped to save the lives of many patients, many of my own patients, but we need to do better, to find treatments that are more tolerable and accessible," Lisanby said.
In order to determine safety and side effects, doctors at Columbia and the New York State Psychiatric Institute induced brain seizures in 10 severely depressed men and women with bursts of magnetic stimulation. They report that these shocks induced fewer memory problems than ECT.
As for the effect on depression, psychiatrists in Europe have reported on one person who got a full treatment course of magnetic shocks. A 20-year-old woman, she felt an almost immediate lifting of her mood, according to psychological measures done after the treatment.
But to prevent relapse, doctors decided she needed further treatment -- with ECT.
