FDA revisits risks of electric shock treatment

They used to call it “Edison’s medicine,” the practice of hooking mentally troubled patients up to an electrical current and jolting them until they went into convulsions, according to a story in the Los Angeles Times.

Pioneered in the late 1930s, electroshock therapy, as it was more commonly known, was a scientifically crude practice that often left patients dazed and disoriented, sometimes with broken bones. For many it became a symbol of the callousness that often characterized the treatment of the mentally ill.

But that was then. Though its use waned as a result of reformers’ attacks and the development of powerful drugs that offered an alternative treatment, electric shock therapy never entirely disappeared. The controversy over its use resurfaced in January when an advisory panel of the Food and Drug Administration met to consider a proposal for changing the official risk classification of today’s electroshock devices.

Influential voices in the mental health establishment, including the American Psychiatric Assn. and the National Alliance on Mental Illness, urged the FDA to drop such devices into a medium-risk category, arguing that modern electroconvulsive therapy, or ECT, as it’s now known, has proved safe and effective over many years of use.

Although medical science still doesn’t understand exactly how it works, modern versions of the treatment offer the last, best hope of patients suffering from extreme depression and several other intractable psychiatric disorders, proponents say.

About 100,000 people, two-thirds of them women, are thought to receive such treatment annually.

“For a very small population of severely depressed people, there’s no other form of treatment like ECT,” said Roberto Estrada, chief of electroconvulsive therapy services at New York’s Lenox Hill Hospital. “It’s for patients who are beyond the reach of conventional psychotherapy and who don’t respond to drugs.”

Others remain sharply critical of the treatment, calling it dangerous, ineffective and often harmful.

“The classification should not be downgraded, and there should be a suspension of its use until it’s proven safe,” said Daniel Fisher, a Boston psychiatrist who argues that the jolts of current cause permanent brain damage. “To me, it’s unbelievable that they’re considering downgrading it. It would be putting it in the same classification as a wheelchair or a syringe.”

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