Electroconvulsive Therapy Essay

Robert Kargher

Electroconvulsive therapy does it really work?
Since its start of use in 1938, electroconvulsive therapy has been in much debate over its practice and effectiveness. Its inventor ladislas Meduna, suggested that by “changing the chemical composition of the brain” through ECT we could effectively treat schizophrenia. As he did not realize that these induced seizures had a lot of major physiological consequences. Were these really psychological changes or were they a combination of biochemical induced changes that had caused some type of neurological
damage that effected there particular alignment?
The controversial history of Ect has never helped this particular therapy among patients of the modern age. From its debut in the 1940’s all the way up to the early 70’s it was considered to be the “ jolt a mental patient needed to get out of their dream world and back into sanity” as stated by one physiotherapist. During the earlier period when convulsive therapies were first being introduced, it wasn’t outlandish to hear commentators explaining it may seem “barbaric” but insanity may no longer be regarded as a hopeless disease.” This revolutionary treatment (ECT) is restoring sanity to thousands of patients.
The rationale for the therapy was that an induced convulsion would disrupt the patients thinking and restore to some sense of reality or “normality”.
As early as the 1920’s one of the first convulsion therapy using insulin was administered on schizophrenic patients. Patients were injected with insulin to induce a coma (sometimes it induced convulsions), than they would inject glucose to wake them up. Even though it had high risk it outweighed the positive benefits it had on the patient. Another drug Metrazol, which was originally used for heart patients, also induced convulsion that appeared to reduce or eliminate a patients’ agitation and psychoses. When electroconvulsive therapy was developed in the late 1930’s by the two Italian psychiatrists, it wasn’t deemed better than the insulin method but was much easier than insulin to administer and better tolerated than metrazol. Thus ECT was becoming the choice over the chemical methods of inducing convulsion in
patients.
By the 1950’s the electroconvulsive therapy was modified with addition of anesthesia and a muscle relaxer. This reduced some of the most severe side effects of convulsion therapy like broken vertebrae and other fractures. In fact by this time electric shock was so well established as a modern effective treatment that journalists described ne medical applications. One of which was about a physician who used electricity on a patient to induce cardiac defibrillation. The physician who was a cardiologist had developed a machine that was based off the ECT. In fact, the first person who received this shock was a nurse in Chicago who became so enthralled wanted to devote her career to psychiatric nursing. Among these discoveries with ECT and all its positive effects none were very conclusive. Though many were very powerful tools for psychiatrist it seemed that was merely a “quick fix” and not a long lasting solution. Many patients complained not only about their side effects but also that there physiatrist weren’t getting to know them as a person. Lucy Freeman, a journalist, who explained this issue said “Some psychiatrist-particular neuropsychiatrists – think people become severely troubled because something is chemically or glandularly wrong with them.”
In the 1960’s as people became more aware of psychoanalysis and new medications for mental illness Ect became less popular. Wasn’t till the 70’s and 80’s did people start to give attention to Ect. There were stories from senators like Thomas Eagleton who after his nomination in 1972 admitted he had been hospitalized and was treated for nervous condition. He was asked to step down shortly after his story went public. Due to the senators success with his treatment and his notoriety psychotherapist began to spur the interest In Ect again.
It wasn’t until the new brain imaging technologies and ailments like Parkinson’s disease did electroshock therapy return to focus. Due to a lot of negative notoriety of its uses as how it was portrayed in movies like “One flew over the cuckoo’s nest and The Snake pit” became a hurdle that still hasn’t been able to jump into with full support. The fears of misuse are common and the movement to abolish or even restrict it has had some success.
Today it is practiced in a hospital with two physicians and nurse present during the procedure. The patient is put to sleep and immobilized with a muscle relaxer. Two electrodes with points to the exact area where they want stimulated are attached to scalp. Than a machine directs a electrical current no more than what a six watts bulb takes to induce a convulsion lasting 30 seconds to a minute. The theory of this is it stimulates the hypothalamus and the pituitary to release cortisol and several other that have psychotropic effects that help treat mania or depression. The other effects of memory loss, severe headaches and unstable mood do not outweigh the positive effects. These brief effects were patients have successfully been treated have a high probability of relapse. In a study conducted by Breggin and Sackeim found a lasting memory dysfunction along with other cognitive deficits. In fact a paper to the FDA concerning the safety of ECT stated that the loss of memory and other cognitive skills is directly related to sever head trauma that you would typically receive in an accident and should be withdrawn as a therapeutic treatment. What’s unusual is even with the new brain imaging technology we find no evidence that supports that any damaged has occurred to the brain that would support this claim.
There are other theories of how Ect works but none really have any solid concrete evidence of what is does or even how it works on our brain.
The only real conclusive things are its memory loss factors with other cognitive loss and the high relapse factor. I don’t it is any more barbaric than simply taking other medications that also impair other functions of the body plus all its side effects. The point is we have choices for each individual case and we should learn as much as we can from each patient and try determine the best therapy that last the longest with as little adverse side effects with best possible
outcome.

Sources 1. Australian & New Zealand Journal of Psychiatry, Aug2006, Vol. 40 Issue 8, p632-638, 7p 2. By: Hirshbein, Laura; Sarvananda, Sharmalie. Journal of the History of the Behavioral Sciences, Winter2008, Vol. 44 Issue 1, p1-18, 18p; 3. Guilfoyle, John. Canadian Journal of Psychiatry, Jan2011, Vol. 56 Issue 1, p13-18, 6p 4. Breggin, Peter R.. Ethical Human Psychology & Psychiatry, 2010, Vol. 12 Issue 2, p139-143, 5p; DOI: 10.1891/1559-4343.12.2.139