On Dec. 23, 2009, the American Psychiatric Association asked the U.S. Food and Drug Administration to class electroconvulsive therapy machines as low-risk devices, citing “strong evidence of [ECT’s] safety and efficacy.”
Currently, the machines are unregulated, falling into a gray area for devices in use before 1976, when the FDA began requiring proof of safety and effectiveness for new medical devices.
Depending on the FDA’s decision, data on clinical safety and efficacy may or may not be required. If the agency classifies ECT machines as Class I or II, there will be no mandatory review; if the devices are ranked Class III, denoting higher risk, safety and effectiveness must be established.
ECT is safer than when it was introduced in 1938. A single point of contact is often used instead of two, and anesthesia prevents the bone-breaking convulsions that were common in the past.
But it is still controversial. Advocates say it is a treatment of last resort for severe depression; opponents point to side effects including possible brain damage and death.
For the estimated 30 percent of patients whose depression remains untouched by medication, ECT might provide relief. Some individuals say it has helped them when nothing else has.
But for others, the treatment is a nightmare.
One such person is Juli Lawrence, 46, of Long Island, N.Y., who told MSNBC that a course of 12 shock treatments in 1994 left her with memory loss and cognitive damage--and did not help her depression. “I was completely devastated,” said Lawrence.
The APA says, however, that the devices are safe. "There's no evidence to show [ECT] machines that we're using now are dangerous if used as indicated," reported Jerry Lewis, MD, a professor of psychiatry at the University of Iowa, and a member of APA. "The electrical current we use…is modulated enough that it doesn't cause any problems. The only issue you might see sometimes is cardiac arrhythmia."
Comments
The APA support for electro-convulsive shock therapy is bewildering even for an organization that certifies, as does the APA, professional care by ballots, and accompanying campaigns. The therapy is well-known for bringing about cognitive distress and memory loss, and is the industrial version of the snake-pit. I suggest it was pronounced harmless because the patients' memory loss prevented them from for remembering its barbarity.There is one advantage for snake-pits. They are cheaper.
Early Greek physicians, inspired by Hippocrates,suggested humane treatment for mental disorders... as well as purgatives. Of course, purgatives were, at the time, the rough equivalent of baby aspirin.
In many ways, it's been downhill since.
Some psychiatric treatments, like isolation and electric shock, outrage the social conscience when employed at Guantanamo, but get a wink and a nod when used on mental patients.
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