This book is well-written and concise. It provides an overview of ECT that is evidence-based yet understandable by the average person. The author effectively uses clinical anecdotes to provide a “face” for the science. The book is organized in a user-friendly way. More »

While ECT remains a remarkably safe and effective treatment for severe depression, its broad application has been hampered by concerns—both perceived and real—about its cognitive effects.⁵ Worries about memory loss make some patients reluctant to undergo this therapy and some practitioners reluctant to refer patients for it. Within the field of ECT itself, there has been tension for some years between the wish to maximize (the already excellent) antidepressant and antipsychotic... More »

Here I will discuss several examples of recent, reasonable depictions of ECT in the media, and I will suggest how they could represent a shift in the way that this “controversial” therapy is regarded. I use the word “controversial” advisedly, because even on the day I write this, a newspaper article on deep-brain stimulation, in which ECT is described, reads: “New reports this month show that some worst-case patients—whose depression wasn’t relieved by medication, psychotherapy, or even... More »

Prognostication is a major part of what physicians do in many fields of medicine, and it is particularly relevant when a treatment or procedure is controversial or anxiety-provoking. Being able to accurately tell a prospective ECT patient how likely he or she is to respond would be helpful. More »

Early relapse is a limiting defect in electroconvulsive therapy (ECT). Although more than 80% of patients with a severe depressive illness who complete an acute course of ECT are relieved within three weeks, up to 60% relapse within six months, despite continuation treatments with antidepressant medications.^1,2 In a large, government-supported, collaborative study led by the Columbia University Consortium (CUC), patients with unipolar major depression that had failed to respond to... More »

Surveys of ECT use in the United States show disparate applications, with the principal use in academic medical centers. While more than half the treatments are given to outpatients, whole populations are underserved. More »

It may come as a surprise, especially given its low repute in the popular mind since the 1980s, but electroconvulsive therapy (ECT) is making a comeback, both as a recommended treatment for depression and in public awareness. More »

Complaints of persistent memory loss in otherwise well-functioning individuals after recovery from a psychiatric illness through electroconvulsive therapy (ECT) are best viewed as a conversion reaction or a somatoform disorder. The Camelford experience is a model for the complaints of ECT's profound personal memory losses. More »

Physicians who use electroconvulsive therapy (ECT) need to be vigilant for unstable medical conditions before and during the course of treatment. This brief review is intended to highlight some basic principles and specific concerns that may be encountered in the use of ECT in patients who have comorbid medical illness. More »

Health-related quality of life can provide a simultaneous and net assessment of the therapeutic and adverse affects of psychiatric treatments for depression. While the cognitive side effects of ECT might be thought of as a limiting factor in HRQOL gains, they have not been systematically studied until recently. Find out what quantitative assessment of HRQOL following ECT for major depressive disorder shows. More »