July 27, 2007

Weighing the Risks and Benefits of Shock Therapy

National Public Radio (NPR) featured a talk show about Electro convulsive Therapy (ECT) or shock therapy that included an interview with some doctors, professionals, and patients who had undergone the procedure. Here, we highlight its relationship to schizophrenia and include the relevant quotes.

Who: National Public Radio (NPR) with anchor: Lynn Neary
When: July 25, 2007 Wednesday
Show: Talk of the Nation 3:00 PM EST

“Weighing the Risks and Benefits of Shock Therapy”

NEARY: just give us a little sense the early days of electroconvulsive therapy, when it was known as electroshock therapy. Who came up with this idea?

Mr. LARRY TYE (Co-Author, "Shock: The Healing Power of Electroconvulsive Therapy"): It was originated in Rome by a physician there who had tried it. He had noticed an effect when they were analyzing the brains of schizophrenics, and have noticed that schizophrenics who had had convulsive - convulsions, naturally occurring epileptic convulsions, it seemed to have an effect on alleviating schizophrenia. And it was first tried in Italy in the late 1930s.

Throughout the 1940s and '50s, it became the treatment of choice in psychiatric hospitals all around the world. And it was largely because there was nothing else available. It was used widely. It was used - probably overused in more hospitals than not, at too many dozes, too high a frequency. That was the only thing that was available then. This is in the days before psycho- pharmaceuticals. So throughout the 1940s and '50s, it was the most widely used psychiatric treatment around the world.

NEARY: And it was thought to be a cure-all of...

Mr. TYE: It was thought to be a cure. Today, we're much - we do it in a different way and with a far greater sense of its potential possibilities and limits.

NEARY: Did this treatment go through something similar within the medical community, as happened in the larger culture, that is it fell out of favor and is now being looked on slightly differently again, or?

Dr. SARAH LISANBY (Brain Stimulation and Neuromodulation Division Chief, Columbia University): Well, I think that's a good parallel. I mean, the medical community is part of the larger culture, isn't it? And so there's a bit of a parallel process when psychotropic medications became available, as Larry Tye mentioned. The medical community began to realize that actually, antipsychotic medications are much more effective for schizophrenia than ECT is.

And in the case of schizophrenia, ECT is really used later on in the course of illness when the condition is unresponsive to most medications. But it was discovered in the medical community that depression responded much more readily to ECT than did schizophrenia. And that took several decades to figure out and that helped to refine what we now consider the indications for ECT. And now, the leading indication for ECT is depression.

Dr. LISANBY: We talked about schizophrenia earlier, and ECT is still used in schizophrenia, though, less commonly. It's more used when most of the medications are not working for severe schizophrenia. But it can be helpful there.

NEARY: Is this covered by insurance, by the way?

Dr. LISANBY: Most insurance programs do cover ECT. Medicare does cover ECT.

Access to full transcripts and audio

More Resources:

Electroconvulsive therapy overview

ECT and Schizophrenia


It was used as a cure all until the late eighties and early nineties in the UK ,patients would be literally queuing up for it and there was a shortage of beds...there are new safety guidelines in the new mental health bill just passed by parliament because they realise there are risk factors involved with ECT.

Posted by: SaltyDavis at July 28, 2007 01:15 PM

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