3 ms·

> If it has changed sufficiently to be essentially unrecognizable vs prior practice, that is probably a good thing... The aversion therapy element is gone enti

by olliej 4y ago

> If it has changed sufficiently to be essentially unrecognizable vs prior practice, that is probably a good thing... The aversion therapy element is gone entirely - it is always performed under general anesthesia, the patient must consent explicitly, and the patient consent and understanding must be checked regularly by a third party. > The real work of the brain & nervous system happens in hundreds of subtle interactions within cells and in the synapses, the patterns of the synapses, etc, and this is just a global sledgehammer. Modern ECT is performed with low voltages applied to specific regions, as this and every other paper involves goes into the details of. > It'll likely have measurable effects, although 50% seems pretty much like toss-a-coin Russian Roulette with your brain. The success rate is greater than 50%, but it's also fairly dismissive to act like there's no cost involved in the alternative. For example, would you be saying "sure there's a 50% chance this cancer cure will save your life, but it has a bunch of terrible side effects, so it's basically Russian roulette" > Perhaps an OK bet in true desperation, but... Again with the dismissiveness. Neither ECT nor ketamine are considered for anything other than extreme cases for which all alternatives have failed, so weighing the side effects of these treatments against the symptoms of mild and/or treatable conditions is kind of shitty? I get it, due to personal experience you are biased against ECT, and so whether a bunch of research demonstrates that it can be beneficial is not relevant to you. But you don't get to then act like the alternative is some kind of panacea free from these side effects that are apparently so bad.

toss1 4y ago
Yes, I get it, modern ECT is very much improved. However, I don't recall even implying or "act[ing] like the alternative is some kind of panacea", and I don't hold such a position, and I don't say there is no cost in the alternative. In fact, it is likely that both are major problems, and will at some point be considered barbaric (as will the cancer chemotherapy you mentioned). All three are deliberate massive disruptions to the entire system, not at all targeting the actual problem, and in fact any benefit is simply a welcome side-effect. An analogy would be a problem in some towns in the midwest US, and ECT is like hitting the zone with a Magnitude 9.3 earthquake and Ketamine/Chemo is like hitting the zone with a massive flood. Sure, the problem may go away, but... The best advances are being made in immunological cancer treatments, which are far more targeted, and looking far more effective. Eventually, we'll be able to know more to know which small subset among the 100 billion neurons and ~quadrillions of synapses to target. Meanwhile, considering either ECT or systemic drugs as much more than a few steps up vs applying leeches is just wrong. I haven't seen a shred of research that indicates understanding of exactly what brain structures are being targeted, and why nevermind what neurons, for ECT or the systemic drugs, and quite a bit on basically empirical, 'well we do this and it gets a desired effect X% of the time'. Sure, that is way better than nothing, and it is all we have, but it is NOT anything like the desired end state of diagnosing IN DETAIL and EXACT problem and it's detailed mechanism, and then repairing it.

by olliej 4y ago

toss1 4y ago

Yes, I get it, modern ECT is very much improved. However, I don't recall even implying or "act[ing] like the alternative is some kind of panacea", and I don't hold such a position, and I don't say there is no cost in the alternative. In fact, it is likely that both are major problems, and will at some point be considered barbaric (as will the cancer chemotherapy you mentioned). All three are deliberate massive disruptions to the entire system, not at all targeting the actual problem, and in fact any benefit is simply a welcome side-effect. An analogy would be a problem in some towns in the midwest US, and ECT is like hitting the zone with a Magnitude 9.3 earthquake and Ketamine/Chemo is like hitting the zone with a massive flood. Sure, the problem may go away, but... The best advances are being made in immunological cancer treatments, which are far more targeted, and looking far more effective. Eventually, we'll be able to know more to know which small subset among the 100 billion neurons and ~quadrillions of synapses to target. Meanwhile, considering either ECT or systemic drugs as much more than a few steps up vs applying leeches is just wrong. I haven't seen a shred of research that indicates understanding of exactly what brain structures are being targeted, and why nevermind what neurons, for ECT or the systemic drugs, and quite a bit on basically empirical, 'well we do this and it gets a desired effect X% of the time'. Sure, that is way better than nothing, and it is all we have, but it is NOT anything like the desired end state of diagnosing IN DETAIL and EXACT problem and it's detailed mechanism, and then repairing it.