January 26, 2011

Not the Only Psychiatrist Who Opposes ECT

By Dr. Peter Breggin

Duff Wilson provided a service by presenting both sides of the controversy when he wrote his report “F.D.A. Is Studying the Risk of Electroshock Devices” in the January 24, 2011 New York Times. The FDA is proposing to move ECT from the high risk category to the medium risk category to avoid the necessity of any testing for safety or efficacy. As a result, ECT would be grandfathered into continued use without ever being tested. This would place ECT in the same category as syringes which no longer need proof of safety or efficacy. The FDA hearings will be held January 27-28, 2011, and I hope some of my more courageous colleagues will attend and testify against approving ECT without testing.

Mr. Wilson quotes me correctly in the article: “It’s a big money-maker,” he [Breggin] said. “I would say if anything it’s been on the increase because there’s a market that’s been exploited, that is the elderly depressed women on Medicare. The reason for that is they’re covered, and there’s no one to protect them. What commonly stops shock treatment is a family member saying ‘over my dead body.’ “

However, Mr. Wilson misunderstood what I meant to say when, without quoting me, he wrote in the original published edition that Breggin “says he is the only American psychiatrist he knows who opposes the treatment.” He and I have chatted since the publication of his article in the NYT and he has generously edited the current on-line copy of the article and posted a correction indicating that I actually said that I am the only psychiatrist I know of who publicly opposes the treatment. I don’t know anyone else who has taken a very visible public stand—publishing anti-ECT views in the scientific literature, and presenting them in the media and the courts. Similarly, I am the only psychiatrist to have testified in a successful ECT malpractice suit.

The same was true when I conducted my successful campaign to stop the resurgence of lobotomy and other forms of psychosurgery in the 1970s. At that time, most psychiatrists probably opposed lobotomy, but I was the first and still only one to oppose it publicly in the scientific literature, the media, and the courts, as well as in Congressional testimony. The success of my campaign required putting outside pressure on facilities, psychiatrists and neurosurgeons who were involved in this barbaric “treatment” and cutting off federal funding for some of their projects. I’m also the only psychiatrist to testify in a successful psychosurgery malpractice trial. My reform efforts against ECT and lobotomy are described Brain-Disabling Treatments in Psychiatry (2008, p. 230-232), ECT is especially harmful to the more fragile brains of the elderly.

ECT causes closed head injury by means of electrically-induced seizures. There can be no doubt that the treatment causes trauma to the brain. The patient is comatose for several minutes in the recovery room and after a few treatments becomes confused and disoriented. A recent study confirms long-term memory loss and other cognitive deficits, which by definition is dementia. As I review in Brain-Disabling Treatments in Psychiatry (2008, pp. 237-241), large animal studies have shown brain cell death using ECT dosages less than those routinely inflicted today. My website has a very extensive ECT bibliography that can be downloaded for free. It includes a variety of the original large animal ECT research projects.

After John Read and Richard Bentall published their recent scientific review, Professor Bentall declared, “The very short- term benefit gained by a small minority cannot justify the risks to which all ECT recipients are exposed. The use of ECT therefore represents a failure to introduce the ideals of evidence-based medicine into psychiatry. It seems there is resistance to the research data in the ECT community, and perhaps in psychiatry in general.”

In a sane society, ECT would be abandoned as a treatment. In an insane society, a government agency would approve it without requiring testing for safety and efficacy. That may be about to happen.

Originally published on The Huffington Post