Duty to Warn: Electroconvulsant Shock Therapy (ECT)

clip_image001[2]Is it safe or even effective?

By Gary G. Kohls, MD

(DULUTH)  In my practice of holistic mental health care, I encountered a number of unfortunate patients that had had one or more series of electro-convulsant (shock) therapy (ECT) , where a series of sub-lethal electrical shocks are administered directly to one or both hemispheres of the brain.

To be regarded as “therapeutic”, enough electricity in this still very controversial procedure (often utilizing up to 400 volts) has to be given to cause a grand mal seizure, which inevitably results in post-seizure coma. Shock to the brain commonly results in memory loss (both short-term and long-term) and the loss of cognitive abilities (both short-term and long-term).

 General anesthesia plus intravenous sedatives are also administered in order to eliminate any memory of the otherwise painful procedure and also to relax muscles (thus minimizing muscle damage and the possibility of fractured bones during the often violent seizure). Both drugs are brain-altering and potentially brain-damaging but are routinely given. The cocktail of futile and potentially neurotoxic psychiatric drugs that may even have caused chemical brain damage are typically continued for fear of causing serious withdrawal syndromes if they were to be stopped.

 Labor costs account for much of the $500 - $1,000 cost for each ECT session, some or most of which is usually borne by health insurance companies. Most ECT is given in a series of 6 – 12 sessions, usually three times per week for 2 – 4 weeks. Besides the attending psychiatrist and an anesthetist or anesthesiologist, a number of other psychiatric staff, including psychiatric nurses, are present as assistants.

 In the ECT-treated patients that came to my clinic, the memory loss and cognitive disabilities (which their psychiatrists had reassured them would be temporary) had actually become permanent, even years after the shock “treatments”. Permanent social security disability status was common, as was difficulty in functioning on the job. (A classic example of one of the many unintended consequence of ECT from history is Ernest Hemingway, who, after complaining of his severe loss of cognition and memory (his main tools as a writer), committed suicide shortly after the second of his two series of ECTs he had received at the Mayo Clinic in Rochester, MN.)

 Every one of my ECT patients had also been treated – usually for years - with high doses of a multitude of powerful, brain-altering (even brain-damaging and dementia-inducing) psychiatric drugs in a bewildering array of guess-work cocktail combinations that failed the patient or made her worse. (It is important to note that no combination of two or more psychiatric drugs has ever been thoroughly tested, short-term or long-term, for safety or efficacy – even in the experimental animal lab. Indeed, most of the trial-and-error psychiatric drug combos that my ECT patients had been given were capable of (according to the Physician’s Desk Reference [PDR]) actually causing worsening depression, lethargy and/or suicidality. So-called “treatment-resistant” depression (drug “poop-out”, drug failure or drug intoxication) and suicidality are reasons commonly given for recommending ECT.

 Given the multitude of exposes in the recent media concerning the high incidence of traumatic brain injuries in Iraq War veterans and NFL football players, it is important to point out that  autopsy studies that have been done on patients who died following ECT show findings very similar to what is found in the autopsies done on traumatic brain injury cases and vaccine brain injuries, namely, cerebral hemorrhages (abnormal bleeding), edema (excessive accumulation of fluid), cortical atrophy (shrinkage of the cerebral cortex), fibrosis (thickening and scarring), gliosis (growth of abnormal tissue) and partially destroyed brain tissue. Consult the bibliography below for proof.

<<<ECT: Another Industry That is Too Big to Fail or Criticize?>>>

Pro-ECT insider organizations, such as the American Psychiatric Association, the AMA and the NIMH have very little oversight from unbiased observers. Indeed, they have enormous conflicts of interest. Even the pharmaceutical industry-subsidized FDA - the so-called “regulatory agency” that rules on the safety and effectiveness of drugs and medical devices - proclaims that patients might “improve” following electroshock. Of course, depending on the reporting parameters of the study, they could just be changing symptomology.

 These for-profit medical industries (including Big Pharma and the medical device industries like those that manufacture ECT machines and accessories) are typically the same ones that design, fund, subsidize, perform, analyze, publish and propagandize the scientific studies “proving” the safety and effectiveness of ECT. Those studies are readily published in mainstream medical journals, which are the journals that get read by average healthcare practitioners. But black-listed whistle-blowers like Breggin only get published in obscure (albeit peer-reviewed) journals that receive no advertising money from Big Pharma and other aligned entities. Of course, the insiders are subjected to essentially no oversight from unbiased observers.

 Interestingly, these biased industry insiders have been forced to admit that they have no idea why ECT seems to “help” the occasional patient. But the best guess as to why patients are different after ECT (ie, from the perspective of the many skeptics who doubt the heavily advertised benefits of sub-lethal electrocution to the brain) is that the memory loss, cognitive disability, post-trauma brain inflammation and the common reliance on personal care-givers (post-ECT) causes patients to ignore or forget the reasons that they entered the psychiatric system in the first place.

 Indeed, by the time patients get to this “Hail Mary” treatment plan, most everybody involved, especially the drugged-up and very vulnerable patient, has forgotten about 1) the (potentially curable through psychotherapy alone) temporary, decompensating, emotional crises, 2) the psych drug-induced brain intoxications, 3) the psych drug-induced withdrawal syndromes and/or 4) the ubiquitous brain malnutrition that led everybody to the conclusion that drastic measures needed to be taken. By ignoring those four common causes for the failure of “standard” treatment, it is not hard to understand why some psychiatrists throw up their hands and try the “last resort”.

<<<Dr Peter Breggin, the Conscience of Psychiatry>>>

Practicing psychiatrist and author (called by many the “conscience of psychiatry”) Peter Breggin wrote an important article (see edited summary excerpts below) for the Huffington Post. In that article, Dr Breggin talks about the various aspects of the ECT industry that are profiting from electroshocking vulnerable patients. Each of them can be expected to resist reformation.

 There are medical journals that are entirely devoted to ECT. Physicians who are trained to perform surgery, do specialty procedures or perform other “gimmicks“ earn a lot more money than non-procedural physicians. The same is true for ECT psychiatrists, for they have incomes that are about twice as large as the average clinical psychiatrist. The anesthesiology industry profits as well. The corporations that design, market and sell expensive ECT machines are very profitable. Those machines often need regular technological upgrades, and thus new machines to replace the old ones that are now proclaimed to be obsolete or inferior.

 Just as happens in many for-profit corporations, there are any number of financial and professional conflicts of interest that manage to deny the strong evidence that proves that electroshock is not good for the brain. Anybody with a little common sense will know that 400 volts of electricity can fry living tissue, especially delicate nerve tissue that can conduct electricity. Everybody understands that lightning strikes or shocks from touching a 120 volt electrical cord is capable of permanently frying skin, nerves and muscles or even stopping the heart. It doesn’t take much imagination to know what 400 volts does to the vulnerable tissues of the brain.

 Below are edited summary excerpts from Dr Breggin’s powerful piece exposing the dangers of ECT, which the mainstream media chose not to comment or expand upon (probably not wanting to disturb the peace or point out the flaws in yet another institution that is too big to fail – or criticize). Please consult the bibliography at the end of the column before reflexively trying to refute Breggin’s premise.

Disturbing News for Patients and Shock Docs Alike

By Peter Breggin, MD – Huffington Post

A team of investigators has recently published a follow up study of electroshock therapy. They have confirmed that electroshock causes permanent brain damage and dysfunction.

 The investigators found persisting memory and mental dysfunction 6 months after ECT. The study’s summary said, “Thus, adverse cognitive effects were detected six months following the acute treatment course. This study provides the first evidence in a large, prospective sample that adverse cognitive effects can persist for an extended period.”

 Traumatic brain damage that persists for six months is likely to remain stable or even to grow worse, (especially if brain-altering psych drugs are also being taken).

 Therefore, the study confirms that routine clinical use of ECT causes permanent damage to the brain and its mental faculties.

 The term cognitive dysfunction covers the entire range of mental faculties from memory to abstract thinking and judgment. In other words, the patients continued to have trouble learning and remembering new things, they were slower in their mental reaction times, and they were mentally impaired across a broad range of faculties.

 Many patients also had persistent abnormalities on the EEGs (brain wave studies), indicating even more gross underlying brain damage and dysfunction. The results confirm that the post-ECT patients, as I have described in numerous publications, were grossly brain-injured with a generalized loss of mental functions.

 Some of the older forms of shock therapy produced the most severe damage; but all of the treatment types caused persistent brain dysfunction. The greater the number of shocks given to patients, the greater was the loss of memory. Elderly women are particularly likely to get shocked — probably because there is no one to defend them. The study found that the elderly and females were the most susceptible to severe memory loss.

<<<Destroying Lives>>>

I have evaluated dozens of patients whose professional and family lives have been wrecked, including a nurse who lost her career but who recently won a malpractice suit against the doctor who referred her for shock “therapy”. Her story is told at my website at www.breggin.com.

<<<Overcoming Decades of Opposition to Shock “Treatment”>>>

This breaking scientific research has confirmed what I’ve been saying about ECT for thirty years. In 1979, I published Electroshock: Its Brain-Disabling Effects, the first medical book to evaluate the brain damaging and memory wrecking effects of this “treatment” for depression that requires inflicting a series of massive convulsions on the brain by means of passing a traumatic electric current through it.

 Over the years, I have continued to write, lecture, testify in court and speak to the media about brain damage and memory loss caused by electroshock. At times my persistence has resulted in condemnation from shock advocates.

 It would require too much autobiographical detail to communicate the severity of the attacks on me surrounding my criticism of ECT. It was second only to the attack on me from the drug companies for (correctly) claiming that antidepressants cause violence and suicide.

 ECT has been found to be no more effective than sham ECT or simply sedating patients without shocking them.

 Will the latest confirmation of ECT-induced brain damage cause shock doctors to cut back on their use of the treatment? Not likely. Both psychiatrists and neurosurgeons always knew that lobotomy was destroying the brains and mental life of their patients, but that knowledge did not daunt them one bit. It required an organized international campaign to discredit, to slow down and to almost eliminate the surgical practice of psychiatric brain mutilation in the early 1970s. The pro-ECT lobby is much larger and stronger than the pro-lobotomy lobby was, and much better organized, with its own journal and shock advocates positioned in high places in medicine and psychiatry.

 Stopping shock treatment will require public outrage, organized resistance from survivor groups and psychiatric reformers, lawsuits, and state legislation.

 (The unabridged version of this essay was published in the journal Ethical Human Psychology and Psychiatry, which is sponsored by the International Center for the Study of Psychiatry and Psychology (www.ICSPP.org).

References (Abridged)

Breggin, P. (1991). Toxic Psychiatry: Why Therapy, Empathy, and Love Must Replace the Drugs, Electroshock, and Biochemical Theories of the “New Psychiatry”. New York: St Martin’s Press. (1992).

 Breggin, P. (1997). Brain-Disabling Treatments in Psychiatry: Drugs, Electroshock and the Psychopharmaceutical Complex. New York: Springer Publishing Company.

 Breggin, P. (1998). “Electroshock: Scientific, ethical, and political issues.” International Journal of Risk & Safety in Medicine 11, 5-40. Breggin, P. and Breggin, G. (1998).

 Frank, L. (1978). (Ed.). The History of Shock Treatment. Available from L. Frank, 2300 Webster Street, San Francisco, CA 94115.

 “Electroshock: Death, Brain Damage, Memory Loss, and Brain Washing”. Journal of Mind and Behavior, 11, 489-512. Frank, L. (2006).

 Friedberg, J. (1977)Electroshock is Not Good for Your Brain. San Francisco: Glide Publications.

 “Shock Treatment, Brain Damage, and Memory Loss: A Neurological Perspective.” American Journal of Psychiatry, 134, 1010-1014. Ross, Colin (2006).

 “The Sham ECT Literature: Implications for Consent to ECT.” Ethical Human Psychology and Psychiatry, 8, 17-28. Sackeim, H., Prudic, J., Fuller, R., Keilp, J., Lavori, P. and Olfson, M. (2007).

 Andre, Linda (2009) Doctors of Deception: What They Don’t Want You to Know About Shock Treatment – Rutgers University Press

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Dr Kohls writes a weekly column for the Reader Weekly, an alternative newsweekly magazine that is published in Duluth, Minnesota, USA. Many of his columns are archived at http://duluthreader.com/articles/categories/200_Duty_to_Warn.

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