Sent: Wednesday, January 30, 2008 12:42 PM
Subject: Latest Electroshock Propaganda--It's the "Penicillin of
Psychiatry"
ALLIANCE FOR HUMAN RESEARCH PROTECTION
Promoting Openness, Full Disclosure, and Accountability
http://www.ahrp.org and http://ahrp.blogspot.com
FYI
The history of psychiatry is a story of megalomania. A confounding
problem
for psychiatry is the profession's failure to examine its therapeutics
from
patients' perspectives or to put psychiatry's therapeutics to a valid
scientific test to determine whether the benefit outweighs the risks
from
patients' perspective.
Suppose someone told you about a treatment for depression that was more
effective than anything else, virtually free of side effects, that is
being
promoted as "the Penicillin of Psychiatry"-would you believe it or
would you
be skeptical? This is what we are told in a new book, "Shock Therapy:
A
History of Electroconvulsive Treatment in Mental Illness" (2007) by
Edward
Shorter, PhD and David Healy, MD. To decide whether this book is
describing
a scientific breakthrough or merely more propaganda, we should consider
some
highlights from the contentious history of ECT.
Thomas Insel, MD director of the National Institute of Mental Health,
recently acknowledged on public television that psychiatry's practices,
unlike other fields of medicine, are governed by the personal
preference--i.e., bias--of a psychiatrist: " the treatments that people
are
given depends not so much on a thorough understanding of mental
disorders,
[but] much more on what it is the therapist is most comfortable in
doing."
http://www.pbs.org/wgbh/pages/frontline/medicatedchild/interviews/insel.html
Indeed, history demonstrates that psychiatrists regularly prescribe
invasive
biological interventions--be they pharmacologic, magnetic, electric, or
surgical-on the basis of conviction (faith) rather than evidence. Sixty
years after its introduction, electroshock (ECS) a.k.a.
electroconvulsive
therapy (ECT), remains psychiatry's most controversial intervention.
ECT is
a polarizing symbol of authoritarianism that continues to be mired in
both
moral and professional controversy. Practitioners are locked in a
bitter
battle against patients who have been harmed and who are fighting for
full
disclosure. ECT's longevity-even as its adherents are fiercely divided
over
the dosage of electricity and method of application (bilateral vs.
unilateral placement of electrodes) [1] confirms Dr. Insel's
observation.
What ECT does to the brain is best described by neurologists who
describe
the measurable pathological changes that are recorded on the EEG,
including
alterations in brain chemistry and physiology. Neuroscientist, Dr.
Peter
Sterling, University of Pennsylvania, provides a detailed description
of
what ECT does to the brain in testimony. [2]
http://retina.anatomy.upenn.edu/pdfiles/Oct2002NYC.pdf
1. The electric shock delivered by a standard ECS machine to the skull
is
roughly comparable to what you would get from a common electrical
outlet,
but the voltage is stepped up from 110 V to 150 V. The total power
drawn is
about 60 Watts -- enough for a conventional light bulb.
2. ECS is designed to evoke a grand mal epileptic seizure. The seizure
causes an acute rise in blood pressure, well into the hypertensive
range,
and this frequently causes small hemorrhages in the brain.
3. ECS ruptures the "blood-brain barrier". This barrier normally
protects
the brain from potentially damaging substances in the blood.
4. ECS causes neurons to release large quantities of the excitatory
neurotransmitter, glutamate, leading to "excito-toxicity" causing
neurons
literally die from overactivity. 5. ECS releases myriad other
neurotransmitters and hormones within the brain. The degree of damage
consequent to ECS varies between individuals. It can be catastrophic in
response to a single series, or it can appear more gradually following
repeated series.
http://retina.anatomy.upenn.edu/pdfiles/Oct2002NYC.pdf
ECT Background:
ECT was originally promoted much as lobotomy had been-as an expedient,
quick, easy, and cheap method of controlling mental patients' behavior.
Early on leading US practitioner / researchers acknowledged that ECT
produces profound, lasting trauma. Lothar Kalinowsky, MD: "All
intellectual
functions, grasp as well as memory and critical faculty, are impaired."
[2]
Abraham Myerson, MD: "The mechanism for improvement and recovery seems
to be
to knock out the brain and reduce the higher activities, to impair
memory."
[3] Max Fink, MD, acknowledged in 1958 that a single ECT treatment is
akin
to "severe head trauma," suggesting that "convulsive therapy provides
an
excellent experimental method for studies of craniocerebral trauma."
[4]
Despite its injurious effects on cognitive function and memory, ECT has
outlasted the other three "brain-damaging-therapeutics"-insulin coma,
Metrazol, and lobotomy. In part, because anesthesia was introduced to
moderate the physical vertebrae and bone-breaking force of the
convulsions
that patients undergo during electrically induced Grand Mal seizures.
However, as an authoritative systematic meta-analysis in Lancet (2003)
reports, neither anesthesia nor other newer methods for applying ECT
have
resulted in an appreciable reduction in other adverse effects. [5]
Three other factors led to ECT's survival after its eclipse in the
1960s and
1970s:
1. Psychotropic drugs did not prove to be the claimed wonder drugs-they
also
caused debilitating neurological side effects, and failed to improve
patients' long-term outcome.
2. ECT economics, which Leonard Frank succinctly outlined: "ECT is a
money-maker. An in-hospital ECT series can cost anywhere from
$50,000-75,000. Using a low figure of 100,000 Americans who are
electroshocked annually, most of who are covered by private or
government
insurance, ECT brings in $5 billion a year." [6] In the US especially,
the
promoters of ECT-- including academic-affiliated practitioner /
researchers,
device manufacturers, and hospitals-all have significant financial
interests
in ECT.
3. The zealous advocacy of its practitioner-proponents-all of whom have
unacknowledged financial conflicts of interest. [7] ECT is dominated
by a
small vocal group of powerful "authority" figures who exert inordinate
influence-indeed, control over ECT research, funding, publications and
practice policies on the basis of their conviction-not scientific
evidence.
Although their financial stake in the business of ECT is rarely (if
ever)
mentioned in their professional academic contributions, no doubt money
plays
a role. Since ECT treatment approaches and outcome evaluations rely
entirely
on practitioners' own preference and assessment, their objectivity is
highly
questionable.
Foremost among ECT's influential proponents is Dr. Max Fink, a
combative
octogenarian who has been applying bilateral ECT longer than anyone.
Dr.
Fink wrote the first ECT textbook, and is credited with formulating the
theoretical foundation, ethical justification, practice guidelines, and
informed consent documents for ECT, actively contributing promotional
material for commercial use. [8]
In September 1978, amidst a heated debate, the first ECT Task Force of
the
American Psychiatric Association surveyed the membership to find out
whether
they thought that ECT was brain damaging. The response by 41% of APA
members affirmed the likelihood that: "ECT produces subtle or slight
brain
damage"-only 26% said no. [9] The Task Force report outlined the ECT
research agenda to address patients' complaints of memory loss. No such
research was carried out.
In 1979 the FDA classified shock machines as a Class III medical
device-indicating it had not been proven safe and effective. Despite
continuing controversy, ECT machines have never been put the test in
controlled trials because manufacturers and ECT practitioners were
adamantly
opposed. The question is, WHY?
If ECT does not cause cognitive damage and memory loss, why have its
proponents failed to conduct a test that will prove them right?
The reason behind ECT practitioners' fierce opposition to performing
controlled clinical trials may found in a 1978 article by Max Fink in
the
official journal of the Psychopathological Association:
"The principle complications of EST [ECT] are death, brain damage,
memory
impairment, and spontaneous seizures. These complications are similar
to
head trauma to which EST has been compared." [10]
Indeed, a cumulative body of evidence confirmed ECT's brain damaging
effects. [11]
Ardent ECT promoters regularly go to battle when threatened with
restricted
use:
By 1983, 26 states had passed statutes restricting ECT and 6 others
established regulations. In 1985, the National Institutes of Health
(NIH)
issued a Consensus Statement confirming: "It is [ ] well established
that
ECT produces memory deficits. Deficits in memory function, which have
been
demonstrated objectively and repeatedly, persist after the termination
of a
normal course of ECT." [12] Threatened with restrictions, ECT's
torchbearers
began a propaganda campaign, vehemently denying evidence of lasting
memory
loss, while resolutely avoiding an examination of the impact of ECT on
memory and cognition
Dr. Fink's pronouncements border on missionary zeal, if not
megalomania.
In 1983, he declared: "If there is no SUBSTANTIAL evidence of brain
impairment, then there is NO evidence for brain impairment." [13]
In 1996, he stated: "ECT is one of God's gifts to mankind. There is
nothing
like it, nothing equal to it in efficacy or safety in all of
psychiatry."
[14]
He pronounced ECT an "effective treatment of patients with major
depression,
delusional depression, bipolar disorder, schizophrenia, catatonia,
neuroleptic malignant syndrome, and parkinsonism.. No age or systemic
condition bars its use." [15]
"Adverse effects on memory have been minimized to the point of being
undetectable, by any means of assessment, six weeks after completion of
treatment." [16]
In 2002, Dr. Fink promoted the use of ECT for children, disregarding
the
profound harm that he himself had documented but now vehemently denies:
"Until demonstrations of untoward consequences are recorded, we should
not
deny the possible benefits of biological treatments to children on the
prejudice that these treatments affect brain functions." [17]
Shock Waives in the Shock Community:
In 2000, the tightly knit ECT cottage industry was confronted with the
most
serious challenge to their vehement public denials that persistent
memory
loss is a risk of ECT. The central supporting stone was pulled from
ECT's
house of clay by Harold Sackeim, Ph.D., an equally prominent ECT
advocate
arguably the most prolific ECT researcher. In an astonishingly candid
editorial in the Journal of ECT, he explicitly validated patients'
claims,
acknowledging that consistent evidence exists documenting that:
"virtually all patients experience some degree of persistent and
likely permanent amnesia. It has also become clear that for rare
patients
the retrograde amnesia due to ECT can be profound, with the memory loss
extending back years prior to receipt of the treatment." [18]
Sackeim further conceded that ECT causes frontal lobe damage
significantly
affecting the brain's executive functions: including working memory,
logical
reasoning and abstraction, problem solving, planning and organizing.
Dr. Sackeim, who simultaneously headed the ECT divisions at Columbia
University and New York Cornell, was the recipient of tens of millions
of
dollars in NIMH research grants collecting data on its effects for two
decades. He was, therefore, in possession of evidence demonstrating
that the
profession's failure to provide evidence of cognitive harm and memory
loss
is not evidence that none exists. "As a field, we have more readily
acknowledged the possibility of death due to ECT than the possibility
of
profound memory loss, despite the fact that adverse effects on
cognition are
by far ECT's most common side effects." [18] [AHRP seeks an electronic
copy
of Dr. Sackeim's editorial] In 2001, Sackeim and his Columbia
University
colleagues reported in JAMA an 84% relapse rate, six months after ECT.
[19]
Seven years after his editorial (2007), he and colleagues published the
data
substantiating his editorial. [20]
"Shock Therapy: A History of Electroconvulsive Treatment in Mental
Illness"
(2007) by Edward Shorter, PhD and David Healy, MD, is not so much a
history
of electroconvulsive therapy (ECT) as it is an unreserved endorsement
and
tribute to Max Fink. Oddly, although he is not a named author, Dr. Fink
states on his website that he is "now working on a book on a History of
Convulsive Therapy with Edward Shorter and David Healy."
http://www.hsc.stonybrook.edu/som/psychiatry/fink_m.cfm
Whatever... The book is clearly written at the behest of Dr. Fink-whose
private foundation, Scion Natural Science Association, provided a
$34,900
grant. http://dfcm.utoronto.ca/research/pdf/grants.pdf
The book serves to bolster Dr. Fink's extreme position in his battle
against
those who argue against the continued use of bilateral ECT because it
has
been shown to cause more cognitive damage. Dr. Fink claims unilateral
ECT
(confined to the non-verbal, right side) is not as effective. And the
book
attempts to deflect the fall out from Dr. Sackeim's confessional
editorial,
which Drs. Shorter and Healy acknowledge, "flabbergasted"
psychiatrists.
Chapter 1, "The Penicillin of Psychiatry?" sets the evangelical,
revivalist
tone, and decidedly unscientific framework of the book.
"So clear are the benefits of ECT for patients who might otherwise
commit
suicide, or languish for years in the blackness of depression, that
there
should be little controversy over whether it is safe or effective." [p.
3]
"Why, today, seventy years after its discovery, is ECT highly
stigmatized,
both patients and many physicians? ECT is, in a sense, the penicillin
of
psychiatry." [p.3]
The authors even adopted Dr. Fink's implausible promotional
pronouncements
extolling the virtues of ECT by adamantly denying its previously
acknowledged, harmful effects. These unreferenced pronouncements are
unsupported by empirical evidence:
"Therapeutic convulsions induced by electricity.do not harm the brain
and
can save lives" [p.9]
"There is no doubt that ECT is effective in the prevention of suicide"
[p.
97]
"There is no known occurrence of brain damage associated with ECT." [p.
104]
"ECT does not lend itself well to abuse because it is painless: the
patient
is immediately unconscious." [p. 94]
"No neurologic sequelae to treatment can be demonstrated." [p. 212]
However, as neurologist, Peter Sterling, MD, noted in his letter in
Nature
(2001),
"ECT damage is easy to find if you look for it."
http://retina.anatomy.upenn.edu/pdfiles/5448.pdf
The credibility of the book is undermined by the authors' heavy
reliance on
Dr. Fink as a source-given his demonstrable bias-and their failure to
present the informed concerns of neurologists who have no stake in this
war.
John Friedberg, MD, the author of Shock Treatment is Not Good for Your
Brain, (1976) was the first neurologist to raise objections against its
use.
In 1977 he wrote in the American Journal of Psychiatry: "Like other
insults
to the brain, ECT produces EEG abnormalities.The potency of ECT as an
amnestic exceeds that of severe closed head injury with coma."[21] He
reviewed the ECT data from six states that mandate reporting of adverse
ECT
effects, and found evidence of brain damage and memory loss. He noted
that
ECT proponents' data frequently belie their claimed findings.
Rather than address the mounting empirical evidence documenting the
case
against ECT-which hinges on its short-lived efficacy outweighed by
long-term
memory loss and cognitive harm [11] [22]-Drs. Shorter and Healy employ
psychiatry's time worn ploy. They divert attention from evidence of its
damaging therapeutics. They frame the contentious controversy
surrounding
ECT as an orchestrated political battle by 'anti-psychiatry' forces
against
the profession-exactly as Dr. Fink has done. They blame Scientology,
the
press / media, the movies, and they blame psychologists for
"stigmatizing"
ECT:
"CCHR and the Church of Scientology have since consistently been the
most
sustained critics of psychiatry and especially of ECT, within the
United
States." [p. 184]
"There is no doubt that in its fantastical depictions of ECT, the movie
industry played a capital role in stigmatizing the procedure." [p. 153]
Ken Kesey's book / movie, "One Flew Over the Cuckoo's Nest," is cited 9
times.
Psychologists, the authors suggest, have sided with patients "as a
tactic in
professional rivalry" using memory loss "as a wedge in battering down
the
citadel of medical authority." [p. 242]
A single controlled study is presented by the authors to substantiate
their
efficacy claims. The study, by Drs. Tillotson and Sulzbach, was
conducted in
1945 at McLean Hospital. Its reported positive recovery results are
described twice, [p. 80, p. 96] followed by the exuberant reaction of
ECT
champion, Dr. Kalinowsky, who brought ECT to the US: "In this group,
amazing
recoveries are achieved in the majority of all treated cases." [p. 81]
"Shock Therapy" authors then claim: "Because of the extraordinary
success of
ECT in medicine, by the late 1940s its curative value was understood in
other areas of American society." [p. 81]
They cite malpractice cases judged on the basis of likelihood of ECT's
curative effect, lamenting the good old days when "there were no
anguished
worries about memory loss, no antipsychiatry groups.and no squeamish
psychologists and social workers shying away from a 'brutal' therapy."
[p.82]
However, they fail to present any of the evidence-from scientifically
valid
studies-that might explain why the protests came about. [11] [22]
How can a credible history of ECT fail to present documented evidence
of
brain damage, memory loss, and cognitive deficits, most reported by
credentialed neurologists and psychiatrists, including ECT proponents?
For example, a 1986 controlled study comparing the brain scans of 101
depressed patients who had received ECT with the scans of 52 normal
volunteers. The study, not intended as an ECT evaluation, found a
significant relationship between ECT treatment with brain atrophy. The
study
also showed that the brain abnormalities correlated only with ECT, and
not
with age, gender, severity of illness, or other variables. [23]
As early as 1950, Dr. Irving Janis, (1950) of Yale University conducted
a
series of well-designed, matched controlled follow-up studies. [24]
These
studies are recognized as methodologically unique in the ECT scientific
literature: their importance is noted by neurologists, independent
scientists, and patients. His method directly addressed the concern of
the
patients and to date is considered the most sensitive and
scientifically
valid. Janis studied the effects of ECT on depressed patients' memory
by
testing them before and after ECT-and by comparing their memory loss
with
matched controls who had not undergone ECT. By examining patients'
memories
2 ½ to 3 ½ months after ECT-and following some of the patients in a
year
long follow up study-Janis could determine whether an individual
patient
showed changes in memory, and whether the ECT group differed from the
matched group of controls. Janis reported that ALL ECT patients had
"profound, extensive" amnesia for at least 10 to 20 life experiences.
The
controls, who had not been subjected to ECT, had no memory
difficulties. No
one has raised serious criticism of the Janis studies. Despite the fact
that
such tests are easy to carry out, no ECT researcher has attempted to
replicate them. Why?
Irving Janis is not even accorded a citation in the index--his findings
are
misrepresented:
"One possibility was that patients actually learned a protective
amnesia, as
opposed to having amnesia directly caused by the treatment." [p. 209]
The authors dismiss patients' testimonies and trivialize their concerns
about memory loss: "In informed circles, serious memory loss has seldom
been
considered real." [p.111] The arrogance betrayed by that statement
mirrors
the dismissive indifference shown by FDA officials who characterized
concerns about an increased suicide risk linked to SSRI antidepressants
as a
"public relations" problem.
http://ahrp.blogspot.com/2007/09/alison-bass-hits-bulls-eye-in-op-ed.html
Drs. Shorter and Healy attribute implausible political power and
influence
to the victims of ECT while failing to discuss the evidence presented
in
recently published authoritative reports. For example, the first-ever,
government sponsored, systematic review of patients' views on ECT
(2003)
[25] was so compelling, it led the UK National Institute for Health and
Clinical Excellence (NICE) to issue new guidelines recommending
cognitive
assessment after each ECT for memory loss; that treatment be stopped if
adverse cognitive effects manifest; the use of validated psychometric
scales; and inclusion of user perspectives on the impact of ECT, and
the
incidence and impact of important side effects such as cognitive
functioning. [26]
The review analyzed 26 studies, 19 conducted by scientists, 7 by former
patients. The findings confirmed other independent analyses: ECT's
efficacy
is short-lived while 30% of patients suffer lasting biographical memory
loss
after ECT. The authors of "Shock Therapy" disparage the review because
of
the presence of former patients on the NICE committee, suggesting: "the
line
between research and advocacy can be a thin one." [p. 249]
"it is not inconceivable that.the Mind representatives heavily
influenced
the document." [p. 250]
Instead of addressing the legitimate medical concerns and the evidence,
the
authors invoke a mystery-shrouded faith: "Why convulsive therapy,
giving
patients epileptic seizures, should be restorative in psychiatric
illness
remains a mystery even today." [p.6]
"The charge of brain damage from ECT is an urban myth, one first put
forward
by the development of a rival therapy, Vienna's Manfred Sakel, who
tried
hard to subvert his competition." [p. 3]
The book was launched on Oct. 24, 3007 at the New York Academy of
Medicine
by Edward Shorter, Max Fink, and Lee Wachtel, MD, who comprised a panel
discussing: The History of Convulsive Therapy from Depression to
Autism:
Past Uses, Future Possibilities.
http://www.nyam.org/initiatives/im-histearch.shtml
Dr. Wachtel is Medical Director and attending child psychiatrist of the
Neurobehavioral Unit at the Kennedy Krieger Institute, with particular
interest in the use of ECT for autistic children. So this book's
launching
was a step toward market expansion with Dr. Fink leading the way by
targeting children for Shock therapy-just as psychiatry's other radical
practitioners are targeting children for expanded use of
antipsychotics. Dr.
David Healy did not attend the book launching.
Accompanying articles to be posted on the AHRP blog:
1. Peter Sterling, MD. Testimony to: New York State Assembly Committee
on
Mental Health Mental Retardation & Developmental Disabilities, July 18,
2001.
2. Sackeim, Harold A. Memory and ECT: From Polarization to
Reconciliation.
Journal of ECT. 16(2):87-96, June 2000.
REFERENCES
1. Richard Abrams, MD Food and Drug Administration Action Is Required,
editorial, Arch Gen Psychiatry 2000; 57:445-446
2. Sterling, P. Testimony Prepared for the Standing Committee on Mental
Health of the Assembly of the State of New York. October 5, 1978.
http://www.ect.org/effects/testimony.html;
3. Kallinowsky, L. Cited by Whitaker, Mad In America, p. 99 Ref. 2.
4. Myerson, A. Borderline cases treated by Shock, Amer. J Psychiatry,
100
(1943): 355-357.
5. UK ECT Review Group (2003) Efficacy and safety of electroconvulsive
therapy in depressive disorders: a systematic review and meta-analysis.
Lancet, 361, 799-808
6. Fink, M. Effect of anticholinergic agent, Diethazine, on EEG and
behavior, Archives of Neurology and Psychiatry 80 (1958):380-386.
In 1966, Fink indicated that his research showed a positive "relation
between clinical improvement and the production of brain damage or an
altered state of brain function." See: Fink, M. Cholinergic aspects of
convulsive therapy, Journal of Nervous and Mental Disease 142
(1966):475-481. And in his 1979 textbook, Dr. Fink wrote: "A more
prominent
neurological sequel to seizures is the change in mental state and the
development of an organic mental syndrome.an organic psychosis may
occur
with few treatments." See: Fink, M. Convulsive Therapy: Theory and
Practice, Raven Press, New York, 1979. Cited by Whitaker, R. Mad in
America,
p. 102, Ref. 2.
7. For example, Richard Abrams, MD does not usually disclose in his
academic
writings that he is President of Somantics, the manufacturer of the
Thymatron ECT device. See: Cameron D. ECT: Sham Statistics, the Myth
of
Convulsive Therapy, and the Case for Consumer Misinformation, Journal
of
Mind and Behavior Winter and Spring 1994, Vol. 15, Pages 177-198. See
also:
Dukakis, K., & Tye, L. Shock: The healing power of electroconvulsive
therapy. (2006). New York: Avery. Furthermore, in sworn court
testimony, ECT
proponents acknowledged their financial conflicts of interest-as will
be
documented in a forthcoming book by Linda Andre.
8. Dr. Fink's videotaped informed consent instructions for ECT are
distributed by Somantics, manufactures of ECT machines. Its owner,
Richard
Abrams, is a close ally of Dr. Fink. [See Ref. 1 above] Given Dr.
Fink's
adamant denial that ECT efficacy is short lived, whereas memory loss
and
cognitive impairments for as many as 30% of patients persist-his
standard
for informed consent is invalid. However, such signed consents may
serve as
liability protection for practitioners.
9. American Psychiatric Association. Report of the Task Force on
Electroconvulsive Therapy. 1978. Survey pp..1-6.
10. Fink M. "Efficacy and safety of induced seizures (ES) in Man.
Comprehensive Psychiatry 19, 1978. Cited by Peter Breggin MD,
psychiatry's
most dreaded, evidence-based critic, in: Toxic Psychiatry, p.199, Ref.
23.
11. Evidence of brain damage,1980+
See: Templer DI, Veleber DM. Can ECT permanently harm the brain?
Clinical
Neuropsychology 1982; 4(2): 62-66; Calloway SP, Dolan RJ, Jacoby RJ,
Levy R.
ECT and cerebral atrophy. Acta Psychiatrica Scandinavica 1981; 64:
442-445.
A retrospective CAT-scan and case review study of 41; Calloway SP and
Dolan
RJ. Ect and cerebral damage Br J Psychiatry.1982; 140: 103a; Templer,
DI and
Veleber, DM. Can ECT permanently harm the brain? Clinical
Neuropsychology
(1982), 4(2): 62-66; Devinsky O, Duchowny MS. Seizures after convulsive
therapy: a retrospective case survey, Neurology. 1983 Jul;33(7):921-5;
Templer DI. "ECT and permanent brain damage." In Preventable Brain
Damage,
Templer DI, Hartlage LC, Cannon WG, eds. New York: Springer Publishing
Co.,
1992; Yousseff and Yousseff Time to Abandon Electroconvulsion as a
Treatment
in Modern Psychiatry, Advances In Therapy Volume 16 No. 1, 1999; Sha
PJ,
Glabus MF, Goodwin GM, Embeier KP. Chronic, treatment-resistant
depression
and right fronto-striatal atrophy. British Journal of Psychiatry 2002;
180:
434-440.
See also: comprehensive ECT bibliography on PsychRights Law Project:
http://psychrights.org/index.htm
See also: annotated bibliography by Linda Andre:
http://psychrights.org/Research/Digest/Electroshock/AndreBibliography.htm
See also: links to many ECT studies:
http://www.ect.org/resources/studies.html
12. Electroconvulsive Therapy. National Institutes of Health Consensus
Development Conference Statement June 10-12, 1985, 5 (11):1-23.
13. Fink M. ECT-Verdict: Not Guilty, Behavioral and Brain Sciences 7,
1984:26-27.
14. Fink quoted in Boodman, SG. Shock Therapy.It's Back, The Washington
Post
September 24 1996, Page Z14
15. Fink M, Convulsive therapy: a review of the first 55 years, J
Affective
Disorders 2001 Mar;63 (1-3):1-15.
16. Fink, M. ELECTROSHOCK: Restoring the Mind. New York: Oxford
University
Press, 1999.
17. Fink, M. Pediatric ECT: Electroconvulsive Therapy in Adolescents
and
Children; Catatonia in Adolescents and Children, Psychiatric Times
September
2002 Vol. XIX Issue 9.
18. Sackeim, Harold A. Memory and ECT: From Polarization to
Reconciliation.
Journal of ECT. 16(2):87-96, June 2000.
19. Sackeim HA, Haskett RF, Mulsant BH, Thase ME, Mann JJ, Pettinati
HM,
Greenberg RM, Crowe RR, Cooper TB, Prudic J. Continuation
pharmacotherapy in
the prevention of relapse following electroconvulsive therapy: a
randomized
controlled trial. JAMA. 2001 Mar 14;285(10):1299-307.
20. Sackeim H, Prudic J, Fuller R, Keilp J, Lavori P, Olfson M. The
Cognitive Effects of Electroconvulsive Therapy in Community Settings
Neuropsychopharmacology (2007) 32, 244-254.
http://www.ect.org/wp-content/uploads/2007/01/1301180a.pdf
21. Friedberg, J. Shock Treatment is Not Good for Your Brain, San
Francisco,
Glide Publications, 1976; Friedberg, J. Shock Treatment, Brain Damage,
and
Memory Loss: A Neurological Perspective, American Journal of
Psychiatry,
134(9) September 1977. pp: 1010-1013.
22. Evidence of memory loss, 1980+
Freeman CP, Weeks D, Kendell RE. ECT II: Patients who complain. Br J
Psychiatry 1980; 137:8-16; Squire LR, Slater PC. Electroconvulsive
therapy
and complaints of memory dysfunction: a prospective three-year
follow-up
study. British Journal of Psychiatry 1983; 142: 1-8; Daniel WF, and
Crovitz
H.F.. Acute memory impairment following electroconvulsive therapy,
Veterans
Administration Hospital, Acta psychiatr. Scand. 1983:67:1-7; Weiner RD,
Rogers HJ, Davidson JR, Squire LR. Effects of stimulus parameters on
cognitive side effects. Ann NY Acad Sci 1986;462: 315-325; Squire LR,
Slater PC. Electroconvulsive therapy and complaints of memory
dysfunction: a
prospective three-year follow-up study. British Journal of Psychiatry
1983;
142: 1-8; Weiner RD, Rogers HJ, Davidson JR, Squire LR. Effects of
stimulus
parameters on cognitive side effects. Ann NY Acad Sci 1986;462:
315-325;
Squire LR, Zouzounis JA. Self-ratings of memory dysfunction: different
findings in depression and amnesia. Journul of CIIRICLII und
Experimental
Neuropsychology 1988; I O(6): 727-738. Diehl DJ, Keshavan MS, Kanal E,
et al
Post-ECT increases in T2 relaxation times and their relationship to
cognitive side effects: a pilot study. Psychiatry Res 1994 (November);
54(2): 177-184; Calev A, Gaudino E, Squires N.K, Zervas I.M and Fink
M.
ECT and non-memory cognition: A review, British Journal of Clinical
Psychology 34 (1995), 505-515; Coleman EZ, Sackeim HA, Prudic J,
Devanand
DP, McElhiney MC. Moody BJ. Subjective memory complaints prior to and
following electroconvulsive therapy. Biol Psychiatry 1996; 39:346-356.
See also: comprehensive ECT bibliography on PsychRights Law Project:
http://psychrights.org/index.htm
See also: annotated bibliography by Linda Andre:
http://psychrights.org/Research/Digest/Electroshock/AndreBibliography.htm
See also: links to many ECT studies:
http://www.ect.org/resources/studies.html
23. Dolan et al. The cerebral appearance in depressed patients.
Psychological Medicine 1986; 16: 775-779. See also: Freeman C.P.L.,
Basson
J.V., and Crighton A. Double-Blind Controlled Trial of
Electroconvulsive
Therapy (E.C.T.) and Simulated E.C.T. in Depressive Illness, The
Lancet,
April 8, 1978; Squire LR, Slater PC. Electroconvulsive therapy and
complaints of memory dysfunction: a prospective three-year follow-up
study.
British Journal of Psychiatry 1983; 142: 1-8;
24. Janis, I. (1948) Memory loss following electric convulsive
treatments.
J. Personality 17:29; Janis, I. (1950a) Psychologic effects of electric
convulsive treatments. I. Post-treatment amnesias. J. Nerv. & Ment.
Dis
111:359-382; Janis, I. (1950b) Psychologic effects of electric
convulsive
treatments. II. Changes in word association reactions. J. Nerv. & Ment.
Dis
111:383-397; Janis, I. and Astrachan, M. (1951) The effects of
electroconvulsive treatments on memory efficiency. J. Abnormal & Soc.
Psychol. 46:501
25. Robertson H & Pryor R. Memory and cognitive effects of ECT:
informing
and assessing patients, Advances in Psychiatric Treatment (2006), vol.
12,
228-238
http://apt.rcpsych.org/cgi/content/abstract/12/3/228
26. NICE ECT Guidelines, 2003: http://www.nice.org.uk/TA059
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