:===Begin Quote=== Electric shock therapy ' better than drugs'; Study supports
controversial treatment
Source: The Herald - Glasgow
http://tinyurl.com/749q
http://infobrix.yellowbrix.com/pages/infobrix/Story.nsp?story_id=37174767&ID=infobrix&scategory=Business+and+Finance&
Publication date: 2003-03-07

ELECTRIC convulsive therapy, immortalised in the film One Flew Over the Cuckoo's Nest, could be better for treating patients with depression than using drugs.

A report published yesterday in The Lancet concluded that there was sound evidence to support the use of electro-convulsive therapy (ECT) in the treatment of short-term depressive illness.

The news will help bolster ECT's position, which has been used in psychiatry since the 1930s, as a mainstream treatment despite its portrayal as being barbaric and ineffective.

Researchers at Oxford University have now claimed that, despite the treatment's association with impaired memory, the technique is fully justified against depression.

Professor John Geddes from the department of psychiatry at Oxford University, said his study was the first to analyse systematically all the available evidence on the psychiatric technique using sophisticated reviewing methodology.

His team reviewed 73 randomised trials which used ECT in a number of different ways with varying doses of electricity and administered on different parts of the patient's head.

Researchers took special note of the decrease in depressive symptoms after therapy, symptom status after a six-month follow-up, the effect of therapy on the brain, and the results of ECT on mortality.

Real ECT was significantly more effective than simulated ECT, and the technique was also far more useful than using some drugs. The positioning of the equipment on the patient was found to be significant.

Professor Geddes said: "There seem to have been a great split between those in favour of ECT and those who think it should never be used. We looked at the evidence and found that it is an effective treatment for relieving depressive symptoms. There was also an indication that it had an effect on cognition in the short term.

"However, it is hard to say if this was directly because of the ECT.

Depression itself can bring about some memory loss.

"Some people will always doubt ECT but there is a good body of evidence that it is effective. There is a trade-off because the higher the dose used in ECT, the better the symptoms of depression are treated.

"But the increased dose may also increase the chance of side- effects."

Last month, Spanish scientists discovered that depressive patients appeared to suffer mental problems during maintenance treatment with ECT.

Previous studies also have shown that acute courses of ECT can lead to adverse physical effects.

Despite having a negative image, ECT was reintroduced to treat certain types of mental illness in the 1970s. ECT, which can be given against the patient's will under the Mental Health Act, became a widespread treatment in the 1940s and 50s when extensive research led to refinements in the procedure.

Its popularity as a clinical tool decreased with the introduction of pharmacological treatments in the 1960s.

Professor Geddes said: "There was a problem with the way the treatment was administered in the past. Patients weren't given enough information about it and it was a lot more frightening.

"Nowadays it is also used with anaesthetic and the convulsion that is triggered is hard to see. The entire procedure lasts minutes. ECT in Scotland is very well thought of. It is taken very seriously in Scotland and a number of audits have shown how well it is practised there.

"ECT remains an important treatment option for the management of severe depression."

Recent concerns have focused on the dose and site of shock administration.
:===End Quote===

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