4 ms·

That's just wrong. I have seen many patients request ECT (many of them are well-educated) because they've tried everything else and are medication resistant. It

That's just wrong. I have seen many patients request ECT (many of them are well-educated) because they've tried everything else and are medication resistant. It's only significant side effects are temporary memory issues. ECT should be used more not less, it is way safer and more effective than many medications psych or not. Patient's are typically brought into a surgical suite, put to sleep and given paralytics as if they were having a surgery. The brain is shocked for like 10 seconds, the patient is asleep and paralyzed, no convulsions happen, no discomfort to the patient. The anesthetics wear off in a couple minutes, the patient wakes up and is able to go home, just as if it were some minor outpatient surgery.

soup10 7y ago
Minimal convulsions happen because they drug the hell out of patients before they are shocked. Otherwise they would be flailing around like a fish out of the water and writhing in pain like they were when they used to do the procedure without anesthesia. It's only more aesthetically pleasing for the medical staff, not safer or more ethical.
jschwartzi 7y ago
I think GP has some kind of axe to grind with mental health practitioners.
- soup10 7y ago
  no more than any of the other patients/victims of the mental health system
- 08-15 7y ago
  Right, and that's not rational, is it? He's probably mentally ill and should be treated professionally.
  - soup10 7y ago
    As someone who has been "diagnosed" with mental illness, I've found that the farther away from the reach of those quacks I am, the happier and more successful my life has been. YMMV
    - jschwartzi 7y ago
      As someone who has also been "diagnosed" I was helped a great deal by therapy and mental health practitioners.
ThrowawayP 7y ago
I dunno; retaining functioning memory is rather important, particularly if one wants to hold down a job. Plus it doesn't jibe with the occasional anecdote of patients who report permanent cognitive dysfunctions after extended treatment. Personally, I choose to believe my clinician, an experienced psychiatrist, who said bluntly to me "You don't want that. ECT makes you stupid." Loss of cognitive abilities is something I (and many techies) can't afford to risk.
- outlace 7y ago
  The prevailing evidence suggests ECT does not appear to cause significant permanent long term cognitive impairment https://www.sciencedirect.com/science/article/pii/S1064748119303392 https://www.sciencedirect.com/science/article/pii/S106474811... https://www.ncbi.nlm.nih.gov/m/pubmed/2053635/ https://www.ncbi.nlm.nih.gov/m/pubmed/2053635/ https://www.ncbi.nlm.nih.gov/m/pubmed/28617690/ https://www.ncbi.nlm.nih.gov/m/pubmed/28617690/
  - ThrowawayP 7y ago
    > "...these summaries report that patient self- reported memory loss tends to be more persistent than the deficits that can be measured on formal neuropsychological testing. However, for those patients who do experience memory or cognitive impairment, they consider this to be a considerable source of distress for themselves and their families." https://psychcentral.com/lib/research-findings-on-memory-and-cognitive-impairment-in-ect/ https://psychcentral.com/lib/research-findings-on-memory-and... > "...We aimed to examine whether long-term effects of ECT on discrete memory systems could be detected in patients with B[ipolar]D[isorder]... Compared with healthy subjects, patients had verbal learning and memory deficits. Subjects who had received remote ECT had further impairment on a variety of learning and memory tests when compared with patients with no past ECT. This degree of impairment could not be accounted for by illness state at the time of assessment or by differential past illness burden between patient groups..." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1911194/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1911194/ I don't think there's sufficient evidence on the long-term effects yet and a high incentive for clinicians to reach for ECT as something that works when nothing else will.

soup10 7y ago

Minimal convulsions happen because they drug the hell out of patients before they are shocked. Otherwise they would be flailing around like a fish out of the water and writhing in pain like they were when they used to do the procedure without anesthesia. It's only more aesthetically pleasing for the medical staff, not safer or more ethical.

jschwartzi 7y ago

I think GP has some kind of axe to grind with mental health practitioners.

soup10 7y ago
no more than any of the other patients/victims of the mental health system
08-15 7y ago
Right, and that's not rational, is it? He's probably mentally ill and should be treated professionally.
- soup10 7y ago
  As someone who has been "diagnosed" with mental illness, I've found that the farther away from the reach of those quacks I am, the happier and more successful my life has been. YMMV
  - jschwartzi 7y ago
    As someone who has also been "diagnosed" I was helped a great deal by therapy and mental health practitioners.

ThrowawayP 7y ago

I dunno; retaining functioning memory is rather important, particularly if one wants to hold down a job. Plus it doesn't jibe with the occasional anecdote of patients who report permanent cognitive dysfunctions after extended treatment. Personally, I choose to believe my clinician, an experienced psychiatrist, who said bluntly to me "You don't want that. ECT makes you stupid." Loss of cognitive abilities is something I (and many techies) can't afford to risk.

outlace 7y ago
The prevailing evidence suggests ECT does not appear to cause significant permanent long term cognitive impairment https://www.sciencedirect.com/science/article/pii/S1064748119303392 https://www.sciencedirect.com/science/article/pii/S106474811... https://www.ncbi.nlm.nih.gov/m/pubmed/2053635/ https://www.ncbi.nlm.nih.gov/m/pubmed/2053635/ https://www.ncbi.nlm.nih.gov/m/pubmed/28617690/ https://www.ncbi.nlm.nih.gov/m/pubmed/28617690/
- ThrowawayP 7y ago
  > "...these summaries report that patient self- reported memory loss tends to be more persistent than the deficits that can be measured on formal neuropsychological testing. However, for those patients who do experience memory or cognitive impairment, they consider this to be a considerable source of distress for themselves and their families." https://psychcentral.com/lib/research-findings-on-memory-and-cognitive-impairment-in-ect/ https://psychcentral.com/lib/research-findings-on-memory-and... > "...We aimed to examine whether long-term effects of ECT on discrete memory systems could be detected in patients with B[ipolar]D[isorder]... Compared with healthy subjects, patients had verbal learning and memory deficits. Subjects who had received remote ECT had further impairment on a variety of learning and memory tests when compared with patients with no past ECT. This degree of impairment could not be accounted for by illness state at the time of assessment or by differential past illness burden between patient groups..." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1911194/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1911194/ I don't think there's sufficient evidence on the long-term effects yet and a high incentive for clinicians to reach for ECT as something that works when nothing else will.