1: Prog Neuropsychopharmacol Biol Psychiatry  2002 Oct;26(6):1029-34 

Effects of chronic antidepressants and electroconvulsive shock on serotonergic
neurotransmission in the rat hypothalamus.

Dremencov E, Gur E, Lerer B, Newman ME.

Life Sciences Faculty, Bar-Ilan University, Ramat Gan 52900, Israel.
dremene@mail.biu.ac.il

The hypothalamus may play a critical role in the pathophysiology and treatment
of depression. There are two main lines of evidence for this: firstly, many of
its functions correspond to those altered in depression; and secondly, many
hypothalamic functions are regulated by the serotonergic system, which is a
common target of antidepressant treatments. In keeping with observations from
other laboratories, we have found that chronic antidepressants and
electroconvulsive shock increase serotonergic neurotransmission in the rat
hypothalamus by inducing desensitization of presynaptic autoreceptors. We have
also found that chronic hypercorticosolemia, which constitutes a model of
depression, has an opposite effect. We postulate that presynaptic autoregulation
of serotonergic neurotransmission in the hypothalamus may play a critical role
in the pathophysiology and treatment of depression.

Publication Types:
    Review
    Review, Tutorial

PMID: 12452522 [PubMed - indexed for MEDLINE]



2: Rev Neurol  2002 Nov 1-15;35(9):805-8 

[Selective alteration of the declarative memory systems in patients treated with
a high number of electroconvulsive therapy sessions]

[Article in Spanish]

Rami-Gonzalez L, Boget-Llucia T, Bernardo M, Marcos T, Canizares-Alejos S,
Penades R, Portella MJ, Castelvi M, Raspall T, Salamero M.

Servicio de Psicologia. Hospital Clinic i Provincial de Barcelona, Barcelona,
Espana.

INTRODUCTION: The reversible electrochemical effects of electroconvulsive
therapy (ECT) on specific areas of the brain enable the neuroanatomical bases of
some cognitive functions to be studied. In research carried out on memory
systems, a selective alteration of the declarative ones has been observed after
treatment with ECT. Little work has been done to explore the differential
alteration of the memory subsystems in patients with a high number of ECT
sessions. AIM. To study the declarative and non declarative memory system in
psychiatric patients submitted to maintenance ECT treatment, with a high number
of previous ECT sessions. PATIENTS AND METHODS: 20 patients submitted to
treatment with ECT (10 diagnosed as having depression and 10 with schizophrenia)
and 20 controls, who were paired by age, sex and psychopathological diagnosis.
For the evaluation of the declarative memory system, the Wechsler Memory Scale
(WMS) logical memory test was used. The Hanoi Tower procedural test was employed
to evaluate the non declarative system. RESULTS: Patients treated with ECT
performed worse in the WMS logical memory test, but this was only significant in
patients diagnosed as suffering from depression. No significant differences were
observed in the Hanoi Tower test. CONCLUSIONS: A selective alteration of the
declarative systems was observed in patients who had been treated with a high
number of ECT sessions, while the non declarative memory systems remain
unaffected.

PMID: 12436375 [PubMed - indexed for MEDLINE]



3: J ECT  2002 Sep;18(3):130-7 

Effect of piracetam on ECT-induced cognitive disturbances: a randomized,
placebo-controlled, double-blind study.

Tang WK, Ungvari GS, Leung HC.

Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, SAR,
China. tangwk@cuhk.edu.hk

Electroconvulsive therapy (ECT) is still the fastest, most effective, and
frequently life-saving therapeutic intervention in several forms of depression
and some other psychiatric disorders. Transient memory disturbances are frequent
after ECT. A randomized, double-blind, placebo-controlled study was conducted to
investigate the effects of piracetam on ECT-induced confusion and memory
disturbances. Thirty-eight consecutively admitted patients with depressive
illness or schizophrenia requiring ECT were given either piracetam or an
identical-looking placebo during the period of ECT treatment and for 2 weeks
afterward. Daily dosage of piracetam was 7.2 g, given orally for the first 2
weeks while patients underwent ECT (loading phase), followed by 4.8 g for the
rest of the study period. Participants were evaluated by standardized clinical
rating scales and cognitive psychologic tests 1 to 2 days before ECT, 1 day
after their third and sixth ECT treatments, and 2 weeks after they had completed
their ECT courses. Piracetam had no significant effect in preventing ECT-induced
memory disturbances. All clinical ratings were consistently, albeit not
significantly, better in the piracetam group, suggesting that piracetam may have
augmented the effects of ECT.

Publication Types:
    Clinical Trial
    Randomized Controlled Trial

PMID: 12394531 [PubMed - indexed for MEDLINE]



4: J ECT  2001 Dec;17(4):264-74 

The portrayal of ECT in American movies.

McDonald A, Walter G.

Chelsea and Westminster Hospital, London, England, United Kingdom.

OBJECTIVE: To describe the portrayal of electroconvulsive therapy (ECT) in
American films. This has not been systematically studied previously, despite
some notorious ECT scenes in the history of American cinema and the impact of
films on audiences. METHOD: All movies depicting or making reference to ECT were
identified from a number of sources. Available movies were viewed on at least
two occasions. RESULTS: 22 films, beginning with The Snake Pit and ending with
Requiem for a Dream, portraying or making reference to ECT were made between
1948 and 2000. 20 (91%) of these movies were obtained and viewed. CONCLUSION:
Having commenced its movie career as a severe but helpful remedy for personal
distress, ECT on film has become a progressively more negative and cruel
treatment, leaving the impression of a brutal, harmful, and abusive maneuver
with no therapeutic benefit.

Publication Types:
    Historical Article

PMID: 11731728 [PubMed - indexed for MEDLINE]



5: Can J Psychiatry  2001 Oct;46(8):720-7 

Transcranial magnetic stimulation in the treatment of mood disorder: a review
and comparison with electroconvulsive therapy.

Hasey G.

Regional Mood Disorders Program, Department of Psychiatry, McMaster University,
Hamilton, Ontario, Canada.

OBJECTIVE: To review repetitive transcranial magnetic stimulation (rTMS) as a
mode of therapy for depression. METHOD: The following aspects of rTMS were
reviewed and compared with electroconvulsive therapy (ECT): history, basic
principles, technical considerations, possible mode of action, safety, adverse
effects, and effects on mood in both healthy individuals and those suffering
from bipolar disorder (BD) or depression. RESULTS: rTMS may selectively increase
or decrease neuronal activity over discrete brain regions. As a result of this
focused intervention with TMS, the potential for unwanted side effects is
substantially reduced, compared with ECT. In open trials, rTMS and ECT are
reported to be equally efficacious for patients having depression without
psychosis, but the therapeutic benefits reported in double-blind sham-rTMS
controlled trials are more modest. CONCLUSION: The antidepressant and antimanic
effects of rTMS depend on technical considerations such as stimulus frequency,
intensity, and magnetic coil placement, which may not yet be optimized.
Biological heterogeneity among the patients treated with rTMS may also
contribute to differing efficacy across clinical trials. rTMS may possess
tremendous potential as a treatment for mood disorder, but this has not yet been
realized. rTMS must still be regarded as an experimental intervention requiring
further refinement.

Publication Types:
    Review
    Review, Tutorial

PMID: 11692974 [PubMed - indexed for MEDLINE]



6: Nervenarzt  2001 Sep;72(9):661-76 

[Use of electroconvulsive therapy in psychiatry]

[Article in German]

Frey R, Schreinzer D, Heiden A, Kasper S.

Klinische Abteilung fur Allgemeine Psychiatrie, Universitatsklinik fur
Psychiatrie, Wahringer Gurtel 18-20, A-1090 Wien. Richard.Frey@akh-wien.ac.at

Electroconvulsive therapy (ECT) has antidepressive and antipsychotic effects.
Since being introduced in Italy in 1938, its mode of action has still not been
clarified. Treatment modalities have changed in many ways. ECT, in which a
generalized epileptic seizure is provoked by electrical stimulation of the
brain, is performed under short intravenous anesthesia and muscle relaxation.
Considering careful previous clinical examination and anesthesiological and
internal counterindications, ECT is a very safe form of treatment. Single cases
of persisting memory impairment were described after the formerly common
bilateral sinus wave stimulation. However, recent developments such as brief
pulse stimulation, unilateral electrode placement, and individual stimulus
titration (on the basis of EEG monitoring) make memory impairment as a
consequence of ECT a rare event which mostly remits completely in 4-8 weeks.
Today, ECT is performed mainly in patients suffering from severe,
therapy-resistant affective or schizophrenic disorders. Pernicious catatonia and
the neuroleptic malignant syndrome are emergency indications. Adequate ECT
treatment requires a series of 6-12 individual sessions (every second or third
day). In therapy-resistant depression, for which the greatest number of data are
available, the response rate lies between 50 and 60%. This has been confirmed by
a descriptive analysis of all ECT treatments at the Department of Psychiatry,
University of Vienna, between 1994 and 2000. There is a need for controlled
studies on continuation therapy subsequent to successful ECT.

Publication Types:
    Review
    Review, Tutorial

PMID: 11572099 [PubMed - indexed for MEDLINE]



7: Am J Psychiatry  2001 Sep;158(9):1527 

Normal PET after long-term ECT.

Anghelescu I, Klawe CJ, Bartenstein P, Szegedi A.

Publication Types:
    Letter

PMID: 11532748 [PubMed - indexed for MEDLINE]



8: J ECT  2001 Sep;17(3):170-4 

Impact of maintenance ECT on concentration and memory.

Datto CJ, Levy S, Miller DS, Katz IR.

Hospital of the University of Pennsylvania and Friends Hospital, Philadelphia,
Pennsylvania 19104, USA. cdatto@mail.upenn.edu

INTRODUCTION: With the increased administration of outpatient electroconvulsive
therapy (ECT), it is important to develop methods for monitoring patients for
adverse effects of treatment. This pilot study was designed to evaluate the
utility of using telephone assessments to determine whether patents receiving
maintenance ECT (MECT) experience cognitive deficits related to individual
treatments. METHOD: Patients were recruited from an existing population of
outpatients receiving MECT. The consenting patients were called on three
occasions and given a battery of telephone cognitive assessments including
Orientation-Memory-Concentration, Buschke Selective Reminding, Verbal Fluency,
"World" Backwards, Serial Sevens, and Wechsler Logical Memory. The occasions for
the telephone interviews were the day before ECT, the day after a treatment, and
a week later. RESULTS: Sixteen patients completed the study. The correlation
between baseline and time 3 ranged from 1.00 for spelling "world" backward to
0.509 for Verbal Fluency Category, indicating considerable variability in
test-retest reliability. One test, Verbal Fluency Category, showed group level
effects, with decrements in performance the day after a treatment. One of the 16
patients showed global cognitive deficits the day after a treatment. DISCUSSION:
The pilot results suggest that telephone assessment may be a useful approach for
monitoring patients receiving outpatient ECT. Monitoring may serve to guide
clinicians in advising individuals and their caregivers about the return to
activities after an individual treatment. Overall these findings support the
tolerability of MECT.

Publication Types:
    Clinical Trial

PMID: 11528306 [PubMed - indexed for MEDLINE]



9: Psychiatr Serv  2001 Aug;52(8):1095-7 

An analysis of reported deaths following electroconvulsive therapy in Texas,
1993-1998.

Shiwach RS, Reid WH, Carmody TJ.

Department of Psychiatry, University of Texas Southwestern Medical Center,
Dallas, USA. raj.shiwach@mhmr.state.tx.us

Since 1993, Texas law has required that all deaths that occur within 14 days of
electroconvulsive therapy (ECT) be reported to the Texas Department of Mental
Health and Mental Retardation. This study attempted to differentiate deaths that
may have been due to ECT or the associated anesthesia from those due to other
causes. Among more than 8,000 patients who received 49,048 ECT treatments
between 1993 and 1998, a total of 30 deaths were reported to the mental health
department between 1993 and 1998. Only one death, which occurred on the same day
as the ECT, could be specifically linked to the associated anesthesia. An
additional four deaths could plausibly have been associated with the anesthesia,
for which the calculated mortality rate is between two and ten per 100,000, but
probably not with the stimulus of the ECT or seizure. The mortality rate
associated with ECT (less than two per 100,000 treatments) in Texas is extremely
low.

PMID: 11474057 [PubMed - indexed for MEDLINE]



10: Eur J Anaesthesiol  2001 Aug;18(8):511-8 

Comment in:
     Eur J Anaesthesiol. 2002 Aug;19(8):614-5; author reply 615.
     Eur J Anaesthesiol. 2002 Aug;19(8):616.

Morbidity in electroconvulsive therapy.

Tecoult E, Nathan N.

Departement d'Anesthesie-Reanimation, CHU Dupuytren, 87042 Limoges Cedex,
France.

BACKGROUND AND OBJECTIVE: To assess retrospectively the complications and
morbidity of electroconvulsive therapy. METHODS: Complications occurring in 75
patients during 612 electroconvulsive therapy procedures under propofol
anaesthesia were reviewed by data analysis. RESULTS: At least one complication
occurred in 51 patients (68%) during the course of their treatment. Among these
complications, 12 were potentially life-threatening: one patient developed
angina pectoris, another aspiration pneumopathy, there were two incidences of
bronchospasm, three hypoxic episodes (SpO2 < 92% with FiO2=1) and five severe
episodes of laryngospasm which caused hypoxia. Twenty-five patients (33%) were
confused for more than 2 h after the electroconvulsive therapy. Confusion
recurred in 10 patients (13%) after several sessions of electroconvulsive
treatment. Six patients had a traumatic complication, with one requiring
surgery. CONCLUSION: Our results, compared with other studies, suggest that
electroconvulsive therapy is not a low-risk procedure, with a particularly high
rate of respiratory complications that may have been previously overlooked.
Therefore, ambulatory anaesthesia may not be appropriate on a regular basis for
most of these patients.

PMID: 11473557 [PubMed - indexed for MEDLINE]



11: Adv Ther  2001 Mar-Apr;18(2):83-9 

The death of electroconvulsive therapy.

Youssef H, Youssef F.

Ross Thomson Unit, Route Hospital, Ballymoney, County Antrim, Northern Ireland.

In Italy, where it began more than 62 years ago, ECT has almost been abolished.
In some countries, however, ECT is still used inappropriately, particularly in
elderly patients. There is no medical, moral, or legal justification for ECT,
and the new requirements of modern psychiatric practice can all be achieved
without it. Like prefrontal lobotomy and all previous shock treatments, ECT is
nonviable. The death of ECT will help promote mental health and put the
treatment where it belongs--in the archaeology of science.

PMID: 11446272 [PubMed - indexed for MEDLINE]



12: J ECT  2001 Jun;17(2):129-35 

Subtypes of memory dysfunction associated with ECT: characteristics and
neurobiological bases.

Rami-Gonzalez L, Bernardo M, Boget T, Salamero M, Gil-Verona JA, Junque C.

Department of Psychiatry and Clinical Psychobiology, University of Barcelona,
Spain.

Electroconvulsive therapy (ECT) is an effective treatment for a variety of
psychiatric syndromes. However, one of its adverse secondary effects is
neurocognitive dysfunction. The aim of this paper is to review different
subtypes of memory dysfunction associated with ECT from a neuropsychological
perspective. Declarative memory is clearly impaired after ECT. Immediate memory,
however, is broadly preserved. Few studies have addressed procedural and
incidental memory. Selective memory is impaired, probably due to the disruption
of specific brain regions. Some of the possible neurobiological bases of ECT
memory dysfunction are discussed in this paper. Synaptic plasticity, the
cerebral neurotransmission system, and cerebral metabolism are examined in
relation to the dysfunction and subsequent recovery of each memory subtype.

Publication Types:
    Review
    Review, Tutorial

PMID: 11417924 [PubMed - indexed for MEDLINE]



13: Actas Esp Psiquiatr  2001 May-Jun;29(3):199-207 

[Mechanism of action of electroconvulsive therapy in depression]

[Article in Spanish]

Rios B, Vincente N.

Servicio de Psiquiatria. Hospital de Mostoles, Jucar, s/n 28935 Mostoles,
Madrid, Spain.

The knowledge of the therapeutic efficacy of the electroconvulsive therapy (ECT)
dates back to the fourties. Since then important investigation efforts have been
carried out, to analyze the mechanism of action by which the ECT achieves its
therapeutic effect.The present work reviews the different hypothesis that have
been related to the mechanism of action or the ECT, as well as the large
neurophysiological findings, believed to be involved in its therapeutic effect.

PMID: 11412495 [PubMed - indexed for MEDLINE]



14: J ECT  2001 Mar;17(1):27-32 

ECS-Induced mossy fiber sprouting and BDNF expression are attenuated by ketamine
pretreatment.

Chen AC, Shin KH, Duman RS, Sanacora G.

Abraham Ribicoff Research Facilities, Yale University School of Medicine,
Connecticut Mental Health Center, New Haven 06508, USA.

Recent evidence suggests hippocampal and possibly cortical atrophy is associated
with major depression. Chronic electroconvulsive seizures (ECS) induce
brain-derived neurotrophic factor (BDNF) expression and sprouting of the mossy
fiber pathway in the hippocampus, effects that may be related to
electroconvulsive therapy's (ECT) mechanism of action. The objective of this
study was to investigate the role of NMDA (N-methyl-D-aspartate) receptor in
mediating the ECS-induced mossy fiber sprouting and BDNF expression. Timm
histochemistry and in situ hybridization methodologies were used to determine
the effect of pretreatment with ketamine, an NMDA antagonist, on ECS-induced
sprouting and BDNF expression. The results demonstrate the ability of ketamine
pretreatment to attenuate ECS-induced sprouting in the dentate gyrus and BDNF
expression in the medial prefrontal cortex and the dentate gyrus. In addition,
we found a significant decrease in seizure duration with ketamine pretreatment.
These data suggest that NMDA receptor activation contributes to both the
regulation of neurotrophic factor expression and the morphological changes
associated with seizure activity. However, other effects resulting from
shortened seizure duration and seizure intensity cannot be excluded. These
findings are of increasing interest, as they relate to the use of ECT in the
treatment of depression, and the specific anesthetic agents that are used.

PMID: 11281511 [PubMed - indexed for MEDLINE]



15: J Psychiatr Ment Health Nurs  2000 Jun;7(3):191-8 

Electroconvulsive therapy: a review of the literature.

Challiner V, Griffiths L.

Department of Social and Polic Sciences, University of Bath, BA2 7AY, UK.

Electroconvulsive therapy (ECT) is a procedure that has been used in the
treatment of mental illness for over 60 years. Despite its continued use it
remains a controversial treatment, with questions concerning its efficacy being
raised not only by mental health professionals, but also service users
themselves. The following article reviews the current literature on the
administration and effectiveness of ECT, highlighting some of the main points of
contention in the debate over its use. In providing a balanced review of the
literature, this article aims to serve as an information source for nurses and
other mental health professionals who may be involved in the administration of
ECT and care of the patients receiving treatment.

Publication Types:
    Review
    Review Literature

PMID: 11249311 [PubMed - indexed for MEDLINE]



16: J Affect Disord  2001 Mar;63(1-3):1-15 

Convulsive therapy: a review of the first 55 years.

Fink M.

Departments of Psychiatry and Neurology, Long Island Jewish-Hillside Medical
Center, Glen Oaks, Long Island, NY 11004, USA. mafink@attglobal.net

Convulsive therapy was introduced to psychiatric practice in 1934. It was widely
hailed as an effective treatment for schizophrenia and quickly recognized as
equally effective for the affective disorders. Like other somatic treatments, it
was replaced by psychotropic drugs introduced in the 1950s and 1960s. But two
decades later, ECT was recalled to treat pharmacotherapy-resistant cases. Avid
searches to optimize seizure induction and treatment courses, to reduce risks
and fears, to broaden the indications for its use, and to understand its
mechanism of action followed. Unlike other medical treatments, however, these
searches were severely impeded by a vigorous antipsychiatry movement among the
public and within the profession. ECT is effective in the treatment of patients
with major depression, delusional depression, bipolar disorder, schizophrenia,
catatonia, neuroleptic malignant syndrome, and parkinsonism, and this breadth of
action is both remarkable and unique. ECT is a safe treatment. No age or
systemic condition bars its use. Its major limitations are the high relapse
rates and the occasional profound effects on memory and recall that mar its
success. Experiments to sustain its benefits with medications and with
continuation ECT are underway. Its mode of action remains a mystery and this
puzzle is an unappreciated challenge. The full impact of this intervention is
yet to be felt.

Publication Types:
    Historical Article

PMID: 11246075 [PubMed - indexed for MEDLINE]



17: Depress Anxiety  2000;12(3):130-4 

Side effects of electroconvulsive therapy.

Datto CJ.

University of Pennsylvania, 3600 Market St. 7th floor, Philadelphia, PA 19104,
USA. cdatto@mail.med.upenn.edu

Electroconvulsive therapy is extremely effective and is the fastest acting
antidepressant treatment now available, although not necessarily limited to use
with depression. Despite years of experience with this technique and its
unparalleled successes, patients continue to be affected by mostly transient,
but sometimes impairing side effects from memory problems and cardiovascular
changes associated with ECT treatments. Nausea, headache, muscle aches, and
other side effects that have been referenced in the literature and clinical
experience will also be discussed in this review. Helpful literature with
recommendations on minimizing the risks of these side effects and improving the
tolerability of the electroconvulsive treatments will also be presented.

Publication Types:
    Review
    Review, Tutorial

PMID: 11126187 [PubMed - indexed for MEDLINE]



18: Prog Neuropsychopharmacol Biol Psychiatry  2000 Nov;24(8):1339-54 

Evaluation of neuronal effects of electroconvulsive therapy by
magnetoencephalography (MEG).

Sperling W, Martus P, Alschbach M.

Department of Psychiatry, University of Erlangen-Nuremberg, FRG.

1. Interictal spontaneous MEG was investigated in five male patients with major
depressive disorder (according to DSM IV) treated with right hemispheric ECT
over a period of five weeks. Spontaneous MEG-activity was also recorded in five
male patients treated with tricyclic antidepressants during the same time
period. 2. The analysis of slow (0-7Hz) and fast (12.5-30Hz) MEG activity was
done with the dipole density plot, which uses consecutively estimated dipoles
across a given analyzing time and delivers quantified dipole concentrations in
three dimensions 3. In the ECT group the authors found a significant increase in
the dipole concentration in the slow activity range (0-7Hz) after the first and
the subsequent treatments, which could not be found in patients treated with
tricyclic antidepressants. The localisation of the dipoles showed an
"anteriorposterior"--gradient with a maximum concentration in the frontal and
temporal region. 4. In the fast activity range (12.5-30Hz) the ECT group
differed from the control group by a significant decrease of dipole activity,
which was concentrated in the temporal and parietal region. 5. These results in
part confirm interictal EEG findings after right hemispheric ECT and also lend
strong support to ECT-effects in the fast activity ranges.

Publication Types:
    Clinical Trial

PMID: 11125858 [PubMed - indexed for MEDLINE]



19: Exp Neurol  2000 Oct;165(2):231-6 

Neurogenesis in the dentate gyrus of the rat following electroconvulsive shock
seizures.

Scott BW, Wojtowicz JM, Burnham WM.

Bloorview Epilepsy Research Program, Institute of Medical Science, Toronto,
Ontario, M5S 1A8, Canada.

Electroconvulsive shock (ECS) seizures provide an animal model of
electroconvulsive therapy (ECT) in humans. Recent evidence indicates that
repeated ECS seizures can induce long-term structural and functional changes in
the brain, similar to those found in other seizure models. We have examined the
effects of ECS on neurogenesis in the dentate gyrus of the adult rat using
bromodeoxyuridine (BrdU) immunohistochemistry, which identifies newly generated
cells. Cells have also been labeled for neuronal nuclear protein (NeuN) to
identify neurons. One month following eight ECS seizures, ECS-treated rats had
approximately twice as many BrdU-positive cells as sham-treated controls.
Eighty-eight percent of newly generated cells colabeled with NeuN in ECS-treated
subjects, compared to 83% in sham-treated controls. These data suggest that
there is a net increase in neurogenesis within the hippocampal dentate gyrus
following ECS treatment. Similar increases have been reported following kindling
and kainic acid- or pilocarpine-induced status epilepticus. Increased
neurogenesis appears to be a general response to seizure activity and may play a
role in the therapeutic effects of ECT. Copyright 2000 Academic Press.

PMID: 10993683 [PubMed - indexed for MEDLINE]



20: J ECT  2000 Jun;16(2):133-43 

Comment in:
     J ECT. 2000 Jun;16(2):87-96.
     J ECT. 2002 Jun;18(2):71-3.

Electroconvulsive therapy and memory loss: a personal journey.

Donahue AB.

The cause for the significant gap between research and anecdotal evidence
regarding the extent of some memory loss after electroconvulsive therapy (ECT)
has never been adequately explained. A patient's development of awareness and
self-education about her severe side effects from ECT raises questions regarding
many current assumptions about memory loss. ECT-specific studies, which conclude
that side effects are short term and narrow in scope, have serious limitations,
including the fact that they do not take into account broader scientific
knowledge about memory function. Because of the potential for devastating and
permanent memory loss with ECT, informed consent needs significant enhancement
until advancing research on both improved techniques and on better predictive
knowledge regarding memory loss progresses to making a greater impact on
clinical applications. Follow-up care and education in coping skills need to be
a regular part of ECT practice when patients do experience severe effects.

PMID: 10868323 [PubMed - indexed for MEDLINE]