Shock Therapy for Depression: Back in Style?

By Vivian Richardson, Ivanhoe Health Correspondent

ORLANDO, Fla. (Ivanhoe Newswire) -- An old treatment for depression is back. It may sound barbaric and outdated, but mental health professionals report shock treatments, or electroconvulsive therapy (ECT), can relieve symptoms of depression, bipolar disorder and schizophrenia.

In the last decade, ECT has made a comeback after the controversial treatment fell out of style in the 1950s, according Stephen Taylor, M.D., from the University of Louisville. He compiled research about the treatment for a recent article. He reported ECT helps nearly 55 percent of patients with drug-resistant depression.

"Treatment-resistant depression is a growing problem in our population," Dr. Taylor told Ivanhoe. "One of the reasons treatment-resistant depression is a growing problem is we're not very good at getting people into remission." Dr. Taylor explained ECT is able to get depression patients into remission more quickly than many other therapies, including medication.

ECT induces therapeutic seizures in patients. Electrodes are placed on the patient's head, and current is passed through the brain. Researchers are not completely sure how these seizures have an effect on mental illness, though some studies have suggested the therapy increases levels of certain brain chemicals, like dopamine. Depressed people have less of these neurotransmitters. "There is a big change in patients who undergo ECT. We do see an up-regulation of those nerve transmitters," Dr. Taylor said. This is similar to what happens when patients use antidepressants, except it happens much more quickly. He also said ECT is safe, citing examples of patients who have had thousands of treatments and suffered no ill effects.

ECT has changed in the last few decades. Dr. Taylor explained patients are given anesthesia and muscle blockers, which keep the patient's body from convulsing to lessen pain and reduce the risk of injury. Before muscle blockers were used, patients risked breaking bones during the treatment. Today's ECT looks nothing like what happened to Jack Nicholson's character in the movie, One Flew Over the Cuckoo's Nest.

In an accompanying editorial, James Kimball, M.D., a psychiatrist at Wake Forest University Baptist Medical Center in Winston-Salem, N.C., wrote ECT may not be right for every patient, but the treatment has a proven track record and should be considered part of the arsenal of treatments for mental illness.

This article was reported by Ivanhoe.com, which offers Medical Alerts by e-mail every day of the week. To subscribe, click on: http://www.ivanhoe.com/newsalert/.

SOURCE: Interview with Stephen Taylor, M.D.; Southern Medical Journal, 2007;100:494-498:462-463

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