Shock Therapy: Old Treatment, New Scrutiny
A controversial treatment of choice for some psychiatrists, electroshock therapy, is under renewed scrutiny.
An expert panel advised the FDA last week that electroconvulsive therapy (ECT) machines should be rigorously tested, as if they were brand new medical devices seeking market approval.
"Shock therapy" has been used for decades. ECT machines shock the brain with electrical current, causing a generalized seizure. Some say it can cure the depressed and save lives.
The wife of former Massachusetts governor Michael Dukakis receives regular shock therapy treatment. Kitty Dukakis is a shock therapy advocate who says it successfully treats her mental illness including depression. Others liken it to torture.
What the FDA advisors decided was: after 70 years of use, there is still not enough known about shock therapy's benefits and risks. Though there are many studies, the FDA advisors said they were often too small, too short-term, or poorly-designed to give a true picture of ECT's long-term safety and effectiveness.
It's estimated that 100,000 patients a year in the U.S. receive shock therapy. It's most often prescribed for depressed patients, but has been used in schizophrenics, catatonics and some other disorders. It's not understood exactly why shock therapy seems to work to improve conditions in some patients. Others complain that it's akin to torture and deleted some of their memories.
If the FDA ultimately accepts the expert panel's recommendation, ECT machines will have to be tested anew except for use in patients with catatonic features.
One psychiatrist who opposes shock therapy, Dr. Peter Breggin, says allowing ECT to continue to be used in catatonics without rigorous testing creates a "loophole."
Breggin theorizes it will lead to more psychiatrists diagnosing patients as catatonics just so ECT can be used. Breggin says shock therapy can lead to long-term memory and cognitive problems.
"It is scientifically unsound to act as though ECT causes serious safety risks with one disorder but not another," Breggin wrote in an opinion article following the FDA expert panel's recommendations.
