Electroconvulsive therapy (ECT), a treatment involving induced seizures to address severe mental illness, may cause a wider range of adverse effects than previously understood. A new study, published in the International Journal of Mental Health, has reignited debate over the practice and led to calls for a temporary suspension pending further investigation.
Beyond Memory Loss: A Broader Spectrum of Harm?
While short- and long-term memory loss are well-documented consequences of ECT, the research identifies 25 additional concerning side effects, including cardiovascular problems, persistent fatigue, and emotional blunting. The study surveyed 747 ECT patients alongside 201 relatives and friends to assess potential harms beyond the immediate aftermath of treatment.
ECT is administered to roughly 2,500 people annually in the UK, primarily for severe depression resistant to other therapies, as well as conditions like schizophrenia, bipolar disorder, and catatonia. The procedure involves delivering electrical currents to the brain under anesthesia to trigger seizures, typically over 6–12 sessions.
Flawed Research, Serious Questions
The study author, Professor John Read of the University of East London, argues that the current evidence base is insufficient to justify continued use. “Given that we still don’t know if ECT is more effective than placebo, these startling new findings make it even more urgent that it be suspended pending a thorough investigation into both safety and efficacy,” he stated.
The research found that nearly a quarter of participants (22.9%) reported heart problems like arrhythmia post-ECT, while over half (53.9%) experienced recurring headaches. Emotional blunting was reported by three-quarters (76.4%) of patients. Some individuals also experienced functional impairments, such as relationship difficulties, navigational challenges, and vocabulary loss.
Patient Accounts: Life-Altering Consequences
Sue Cunliffe, a former ECT patient, describes the treatment as having “completely wrecked my life.” She reports lasting speech impairment, tremors, balance issues, and cognitive deficits that prevent her from working as a doctor. “A week before ECT I was on a running machine, playing badminton and able to write poetry, and six weeks later I’m falling down stairs, bruised,” she said.
Divided Opinions Among Professionals
ECT remains a polarizing treatment within mental health circles. While some clinicians report positive outcomes, questions persist about its efficacy and long-term effects. Professor Tania Gergel, director of research at Bipolar UK, asserts that there is “no evidence to substantiate claims that modern ECT carries any major risk to physical health or that it causes long-term brain damage and permanent deterioration of cognitive functioning.” She stresses its utility in stabilizing acute symptoms, allowing patients to engage in broader recovery strategies.
However, Professor George Kirov from Cardiff University highlights ECT’s “highly effective” nature, observing improvements in 60% of severe depression cases. He attributes under-utilization in the UK to stigma, noting its more frequent use in Northern Europe. Kirov contends that meta-analyses demonstrate ECT’s superiority over antidepressants and other interventions.
Ethical Concerns and Vulnerable Populations
Lucy Johnstone, a clinical psychologist, points to systemic issues surrounding ECT administration. She emphasizes that few patients are fully aware of the procedure’s continued practice and that older women are disproportionately affected, with one-third receiving it against their will. She also notes a concerning correlation between ECT use and domestic abuse among patients, suggesting that the treatment is sometimes deployed when other interventions fail.
Regulatory Oversight and Future Research
National Institute for Health and Care Excellence (NICE) guidelines restrict ECT to acute, life-threatening cases, patient preference based on prior experience, or treatment-resistant situations. Accredited clinics are required to record data on delivery and outcomes. However, calls for increased regulation and further research into long-term effects continue.
The debate surrounding ECT underscores the need for rigorous assessment of both its benefits and risks, particularly given the potential for irreversible harm.
The ongoing controversy highlights the urgent need for more robust, placebo-controlled trials to determine whether ECT’s efficacy justifies its known side effects.
