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|Fictional and semi-fictional depictions of ECT was nominated for deletion. The debate was closed on 16 April 2010 with a consensus to merge. Its contents were merged into Electroconvulsive therapy. The original page is now a redirect to here. For the contribution history and old versions of the redirected article, please see its history; for its talk page, see here.|
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- 1 Untitled
- 2 Voltage?
- 3 bipolar manic depressive disorder cluster personality disorder
- 4 Status Epilepticus
- 5 Mind Control?
- 6 Electroconvulsive therapy (ECT) and Deep brain stimulation (DBS)
- 7 List of people who have undergone ECT
- 8 Too Long Label
- 9 NEW ARTICLE FOR ECT CONTRAVERSY
- 10 Psychoanalysis
- 11 Stats for rates of administration of voluntary and involuntary ECT in the USA
- 12 Article Lead Might Need a Rewrite
- 13 Effects related to endorphine / mu-receptor stimulation?
- 14 Unsupported assertion
- 15 ECT&DST as possible cause of brain damage
- 16 Removed badly written and un-sourced content
- 17 Unreferenced paragraph removed
- 18 POV and weasel words
- 19 Carol Kivler testimonial and mechanism of action
- 20 Rollback of edit to "There is a significant risk of memory loss with ECT"
- 21 Actual examples should be removed
- 22 Citing sources behind paywalls
- 23 I hope an editor will make corrections to the "administration" section.
- 24 section of text for deletion
- 25 Mechanism of Action
- 26 Needed Citation in Adverse effects: Effects on memory
- 27 Introduction Paragraph
- 28 False gender gap removed
- 29 Early history
- 30 Section mentioning Dr. Peter Breggin is biased
- 31 Cancer and ECT
- 32 10.1 Fictional Examples. A Beautiful Mind inaccurate
- 33 POV takeover of page- needs work being restored to NPOV
- 34 Negative patient reports
- 35 Use of uncommon words
- 36 Balanced?
- 37 Alleged copy vio
- 38 edit warring over content based on outdated review
- 39 ECT mania addition
- 40 Edits under "Usage"
- 41 Header Photo?
- 42 Additional famous persons
What are the typical voltages used for this? I think that should be added to the article, perhaps under the 'equipment' section (where it does mention the typical current used). —Preceding unsigned comment added by 22.214.171.124 (talk) 21:26, 30 March 2009 (UTC)
- Its usually over 9kV. —Preceding unsigned comment added by 126.96.36.199 (talk) 06:55, 7 May 2009 (UTC)
If the regulating factor is flow, and it is balanced somehow, at least mention the potential forces (volts) involved with this. The only way you could control the flow is by adjusting the resistance or force.... Msjayhawk (talk) 03:12, 26 January 2010 (UTC)
A number of parameters should be considered. In the article the Current and Power levels were statated. The Voltage can be determined by dividing the Power level by the Current level. However, just as important are electrical waveforms and frequencies (e.g. sine-wave/pulse), pulse durations, and currents. The currents and their waveforms have the greatest effect. Remember, a common static-shock can be as much as 20,0000 volts and be nothing more than an annoyance. —Preceding unsigned comment added by 188.8.131.52 (talk) 15:57, 21 February 2010 (UTC)
Voltage is related to resistance of the human subject which is guessed at with an ohm meter before the procedure. Also there is the break down threshold in the material, as in once electricity starts to flow through a pathway the previous resistance drops dramatically. Very similar to lightning.--Mark v1.0 (talk) 13:15, 22 September 2013 (UTC)
bipolar manic depressive disorder cluster personality disorder
would this be help ful in these cases well they are for one person me ive tried many diffirent drugs and have little hope to be what pepole call normal
- Wikipedia as a rule doesn't offer medical advice. But in all honesty, would you really want highly specialised medical advice from somebody randomly over the internet, of uncertain qualifications, who's unfamiliar of your complex circumstances and unable to evaluate you properly? I suggest you discuss medical decisions such as these with your psychiatrist for a more personalised, trustworthy, and intelligent answer. 184.108.40.206 (talk) 17:01, 15 October 2009 (UTC)
He never said he was normal, lol SonicNiGHT 09:01, 27 August 2010 (UTC)
I did not see this listed, but ECT is also used to treat status epilepticus. Is there any reason why this is not in the article? —Preceding unsigned comment added by Mkayatta (talk • contribs) 14:51, 22 July 2009 (UTC)
ECT is documented to be a CAUSE of non-convulsive status epilepticus. ECT has been used to treat other mental disorders or neuropsychiatric symtpoms as well, but they aren't all listed in this article. It's main uses are listed in the article. Danrz (talk) 04:43, 13 September 2009 (UTC)
ECT may induce a non-convulsive status and EEG monitoring is in place to catch that. However, status that happened all on it's own CAN be controlled with ECT as ECT itself increases seizure threshold. —Preceding unsigned comment added by 220.127.116.11 (talk) 21:19, 23 October 2010 (UTC)
I removed the movies "A Beautiful Mind " and "Regeneration" from Fictional and semi-fictional depictions Character in A Beautiful Mind receives Insulin Coma Treatment and the treatment in Regeneration is not ECT but an electric current given through the mouth. —Preceding unsigned comment added by S. Belt (talk • contribs) 12:57, 19 November 2009 (UTC)
Given the amount of controversy it seems placing this article under the category "Mind Control" would be comparable to creating a category titled "Beneficial and Harmless Psychiatric Treatments" and placing it alongside Mind Control and Human Rights Abuses. I can much more clearly see the argument for leaving it in the latter category but the term Mind Control seems strikingly biased to me. I'm going to be bold and remove it but if I am in the wrong I would like very much to hear why that is an appropriate label. 18.104.22.168 (talk) 00:04, 27 November 2009 (UTC)
Only possible justification would be in regard to Ewen Cameron's use of ECT to depattern people in Montreal. For what it's worth, I think you're right to remove the categorisation though. Freekra (talk) 00:49, 27 November 2009 (UTC)
- I wasn't aware of the categorization on this page, but there is a history of experimental use for this purpose. For example, the Montreal case mentioned above. Also, highly notable is the use by psychiatrist HC Tien. See here, and also here. And there's more. Read about its history in New Zealand, for example. So, at least from a historical and experimental perspective, yes, it's been used for this purpose. And as to other types of abuse, read about how it was forced on Chinese children recently because they were spending too much time on the internet. Danrz (talk) 02:16, 27 November 2009 (UTC)
- Also, as its action remains unknown, it is still essentially an experimental procedure. I've created a category "Human experimentation in psychiatry" to which I've added this page. This category is not meant to equate to a moral judgement or condemnation of any particular practice but to be used when any procedure in psychiatry meets the criteria of being an experimental procedure.FiachraByrne (talk) 09:17, 8 March 2011 (UTC)
- Did they use it during the MKULTRA years? I know there have been some people who have testified to some pretty extreme abuses from the program. Given that the CIA destroyed most of the documents of the project to protect themselves from criminal liability, if we can find victim testimony and include it, it would be relevant to the category. I think it would be folly to think that among the hugely illegal and unethical things that CIA did in the years of publicized mind control projects that ECT never crossed their mind. It may have been a conspiracy theorist that put it under this category, but the use of extreme experimental procedures in the pursuit of psychological control is well documented.Bloomingdedalus (talk) 19:58, 18 June 2011 (UTC)
- Update -- I have found a source from the Indiana School of Medicine, Center for Bioethics which confirms that ECT was employed during MKULTRA, I have not thoroughly examined the main page to see if there is a reference to it's use in regards to this program or others is cited or mentioned, but it does justify the category of "mind-control" which makes no judgments as to the efficacy of ECT in achieving "mind-control" (whatever that constitutes): http://bioethics.iu.edu/reference-center/ect-mkultra/ Bloomingdedalus (talk) 22:17, 19 June 2011 (UTC)
Electroconvulsive therapy (ECT) and Deep brain stimulation (DBS)
I wonder if Electroconvulsive therapy (ECT) should be linked to Deep brain stimulation (DBS) as both are used for the similar reasons (mental health) and involve the use of electricity. --Antidote 13:43, 9 April 2010 (UTC)
List of people who have undergone ECT
The inclusion of Dave Mustaine on the list appears to be in error. The interview used as a source has Dave Mustaine describing how he received "electric shock" therapy to increase the mobility of his arm after an injury, to make him capable of playing guitar again. This sounds like it was not ECT some sort of electrical stimulation procedure that would be performed on the nerves and/or muscles of the arm since it has nothing to do with the central nervous system and was not a psychiatric procedure.22.214.171.124 (talk) 00:51, 9 May 2010 (UTC)
- I've removed him from the list. Per the citation, it sounds like he simply had TENS therapy to his arm, not ECT. --CliffC (talk) 21:35, 17 October 2010 (UTC)
Too Long Label
I totally agree with this. I also get feeling that the article is so long in order to placate the anti-ECT agitators who would rather this article be their own soap box, no?126.96.36.199 (talk) 20:52, 17 October 2010 (UTC)
NEW ARTICLE FOR ECT CONTRAVERSY
I think the ECT controversy is so important and so complex since there are multiple mechanisms of controversy that this should be its own web page or an extended one. —Preceding unsigned comment added by 188.8.131.52 (talk) 20:45, 28 November 2010 (UTC)
- Wikipedia doesn't generally encourage content forks until an article grows quite large, so as to keep all related material together. Right now the article doesn't seem that large. --CliffC (talk) 22:45, 28 November 2010 (UTC)
- I actually think that this is a good idea given the article length and problems with its current structure. However, this should not be used as an opportunity to elide any controversial aspects of the treatment in the main article. These should be treated, but succinctly.FiachraByrne (talk) 09:20, 8 March 2011 (UTC)
I have an ancient dog-eared book written by psychoanalyst A.A. Brill in 1938. Here's what he had to say about this subject:
"A chronic schizophrenic may remain in a hospital for years in a state of indifference, but now and then he may suddenly act like a rational being. Sometimes a severe shock, such as an accident or illness which threatens his self-preservative instinct, brings the schizophrenic back to reality for a time. The latest form of therapy for schizophrenics is based on this very idea. I am referring to the insulin or, as it is called, the shock therapy, because the patient receives such a shock through the hypogycemia that for a time at least he gives up his phantasy world. But it matters little whether hypoglycemia cures or only produces a transient change; the fact that schizophrenics occassionally return to normality spontaneously and then relapse, and the fact that an accidental or experimental shock can drive them back to reality at least for a time, clearly shows that the psychotic, too, is not altogether detached from reality."
(*The Basic Writings of Sigmund Freud* [introduction] A. A. Brill, The Modern Library, 1938. pg.23-24.)
I have to wonder if modern medicine is beating its head against a wall in futile reductionist attempts to find physical explanations for a purely psychological phenomenon, even to the point where common sense is abandoned. Snud (talk) 23:13, 28 November 2010 (UTC)
- Well, this isn't place to do that. Also, the quote you cite betrays your notion anyway. That's like a murderer showing a photo of him murdering while saying "You have to wonder why people murder, I don't get it." Why are you wasting space here?184.108.40.206 (talk) 06:20, 5 December 2010 (UTC)
- I thought it was interesting. It made me think about something I never thought of before. Are you not interested in thinking about it? Isn't this a discussion page? Haven't I provided documented facts you didn't know before? I do realize that my information might be disturbing to the lambs, but I know you aren't one of those.Snud (talk) 05:56, 6 December 2010 (UTC)
- Come to think of it, I'm getting tired of people preferring incomprehensible gobbledy gook reductionistic explanations for mental illness rather than emotions and drives. What's wrong with common sense, huh? Nowadays it seems that mental illness no longer exists; just nerve damage. It's so naive and simple minded I'm getting sick of it. You know, there are still no neurological, lab or genetic tests for any mental illness, and therefore no mechanical explanations for the efficacy of ECT, so please take YOUR foolish, la de dah objections elswhere!— Preceding unsigned comment added by 220.127.116.11 (talk • contribs)
- The quote you used was talking about insulin shock therapy, not Electroconvulsive therapy. If you don't know what hypoglycemia means, perhaps you should use a dictionary before including quotes irrelevant to topics. The physical underlies everything, which is why legitimate scientists look to the physical for a set of symptoms. The point of this quote is that the psychiatrist was intentionally putting someone in mortal danger to see if it would draw someone back to a "realistic" view of the world. That being said, 1938 is hardly "modern" medical practice, it's a rapidly changing field which has exploded in complexity and knowledge in the past 80 years. I do share your skepticism toward some psychological diagnosis, but there are also people who are very clearly and realistically affected by mental illness, if a man says he sees 10 foot tall snails following him, he's probably hallucinating. If you want to understand the truth and limitations of neurology vs. psychiatry, I suggest you start by learning the word "hypoglycemia" and continue studying from there. I have that exact edition of Freud, by the way, on my shelf: 1938, Modern Library, Basic Writings, introduction by Brill. The next place you should start is Martha Mitchell then get a solid neuroanatomy book and put down Freud for a while. Bloomingdedalus (talk) 20:13, 18 June 2011 (UTC)
- As you say 1938 is hardly modern medical science, yet today we still use the terms and definitions they invented at that time like (psychotic). Penicillin had not even been used to treat syphilis a physical illness believed to be a mental illness. Today science can see the smallest thing and can not find a physical cause to mental illness. If science did find a physical cause, the illness would then be a Neurological disorder not mental illness. --Mark v1.0 (talk) 13:51, 22 September 2013 (UTC)
Stats for rates of administration of voluntary and involuntary ECT in the USA
There does not appear to be any recent stats (i.e. within the past 20 years) for the use of ECT on either a voluntary or involuntary basis for the US. Therefore, the surgeon general's statement on the rate of involuntary ECT use as "uncommon" is not simply ambiguous, but, I think, currently unsupported. I've changed the lead, citing what data I could find, to reflect this. Does anyone have any national data for the use of vol and invol ECT that could be added to the article?FiachraByrne (talk) 11:38, 24 February 2011 (UTC)
- Any stats again on ECT usage worldwide or elsewhere would be appreciated. I know there are statistics for the England, Wales, Scotland and Ireland (republic of) and also Australia. Italy we know hardly has any ECT. Are there stats for any other jurisdictions? Could people post any sources on stats here. The US stats, which are a bit questionable anyway (based on clinicians recollection of how often they've used ECT) date from about 1988-89 I think. Other than Texas there are no current stats for the US. FiachraByrne (talk) 09:26, 8 March 2011 (UTC)
Article Lead Might Need a Rewrite
I think the lead for this article is impressionistic, defensive, and somewhat ideological. I think it could do with a rewrite including only material that has a solid empirical base. I don't think it should seek to champion or denigrate the procedure but simply to reflect what information there is out there on it, good and bad.FiachraByrne (talk) 13:28, 24 February 2011 (UTC)
- I agree. I tried to clean up some of the more egregious problems. But the task of streamlining this is a bit daunting, especially considering the expected resistance.JohnDO|Speak your mind 05:00, 6 March 2011 (UTC)
- Well, I suggest we just look at each statement in the article and see is it justified. For instance the statement that 1 million people receive ECT worldwide relies on a pretty weak source. I don't think that a simple statement by Larry Tye, a medical reporter, is sufficient to support this claim. Are there any real figures for ECT usage. 20:03, 6 March 2011 (UTC)
- OK - I've removed unsubstantiated statements from the lead (e.g. numbers worldwide receiving ETC, etc). I've also reformulated statement that ECT is regarded as safe and effective stating that this is the view held by the majority of psychiatrists (which is supported) but that it remains a controversial procedure as reflected in popular opinion, legal restrictions on its usage, disputes within psychiatry and medical profession (and indeed other mental health professions) as to its efficacy and safety. Also that it has been recently decided by FDA to maintain it in Class III devices (highest risk). I think these additions are factual and balanced. There are other items I'd like to tackle in the lead - not least the general bias, also quite evident in the article, to treat ECT as if it were solely or predominantly an American phenomenon with passing references to the UK. But I think for now it is best to move on to the main body of the article. We need to think about which sections would make good sub articles. FiachraByrne (talk) 04:37, 8 March 2011 (UTC)
- I think an obvious choice would be to create a new page entitled the History of electroconvulsive therapy and retain at most a paragraph or two -very tightly written and hitting on all the points pertinent to its present use and image - of the history of ECT. However, this will require the preparation of a decent article, incorporating the info here, on the history.FiachraByrne (talk) 09:14, 8 March 2011 (UTC)
- Well, I suggest we just look at each statement in the article and see is it justified. For instance the statement that 1 million people receive ECT worldwide relies on a pretty weak source. I don't think that a simple statement by Larry Tye, a medical reporter, is sufficient to support this claim. Are there any real figures for ECT usage. 20:03, 6 March 2011 (UTC)
Release of endogenous opioids following transcutaneous electric nerve stimulation in an experimental model of acute inflammatory pain., has it ever been considered that the affects of ECT may be mediated via the opioid system? 18.104.22.168 (talk) 23:03, 18 July 2011 (UTC)
This is an excellent presentation because it includes the failure of evidence.
Unfortunately, the opening description plainly violates the rules of science by asserting that electrovonvulsive therapy is "effective"
- I don't see what you are complaining about. The article does not assert the ECT is effective, it only says that the majority of workers regard it as effective, and it gives a number of references to back up that assertion. Looie496 (talk) 17:42, 14 August 2011 (UTC)
ECT&DST as possible cause of brain damage
I am not normally a wikipedia editor so I don't know how to incorporate this information. Injuries have occurred because of use of ECT with DST (Deep Sleep Therapy) in Australia at Chelmsford Private Hospital that lead to hypoxia or anoxia in the patient. A judgment from the Australian NSW Supreme Court in which medical experts outline how in this case brain damage occurred. [ http://www.austlii.edu.au/cgi-bin/sinodisp/au/cases/nsw/NSWSC/1997/168.html ] The relevant subheading is ECT as possible cause of brain damage in the judgment.
ECT has long been regarded as an appropriate physical treatment for some types of psychiatric illness, especially depression (cf. Bolam v. Friern Hospital Management Committee (1957) 1 WLR 582) although the situations accepted by the bulk of medical practitioners as appropriate for its use have been progressively circumscribed as various forms of psychiatric illness have become better understood, and as other, less traumatic, forms of therapy have been developed. It is a treatment which involves some well recognised risks. (Again I interpose to say that nothing I now say about ECT or the circumstances in which it was used in respect of the plaintiff is intended as in any way bearing on any question of liability which may ultimately need to be resolved; I expressly refrain from any comment on the question whether in the circumstances of this case, the administration of ECT and the manner of its administration were appropriate). ECT involves the sending of an electric charge through the brain and that has an effect on the oxygenation process to the brain. Dr. Phillips explained it, saying:-
"... it is certainly more than an instant. There are two parts to this. There is the actual moment of the electrical impulse, which will vary, depending on the machinery used and a variety of other factors, and respiration will be stopped momentarily then. That does not matter particularly. The patient then, and this is why ECT is used, the patient will then have an epileptic seizure. The first phase of an epileptic seizure is a phase whereby the patient goes into muscle spasm and during that phase, which can last from seconds to over a minute, respiration will cease. The patient then goes into the second phase of the epileptic seizure, which is a phase of contraction and relaxation of muscles, the characteristic, the lay idea of the seizure, and respiration will be disordered but will continue during that period. So it is the phase, the tonic phase, the tonic phase of contraction of muscles during which respiration ceases that is my concern in relation to anoxia."
The risk of anoxia during ECT being well recognised, usual practice according to Dr. Phillips (again without challenge or contradiction) is for the patient to be oxygenated prior to the actual electro-convulsion and as quickly as possible following the tonic phase of the epileptic seizure. There is no evidence that oxygen was given on occasions when ECT was administered to the plaintiff. — Preceding unsigned comment added by 22.214.171.124 (talk) 14:02, 9 December 2011 (UTC)
- Thanks, but testimony in a court case involving an unusual way of using ECT would not constitute an appropriate source for this article. The minimum we would need would be newspaper coverage, and discussion in an academic review paper would be much better. There is a large literature on the potential of ECT to cause brain damage, so we don't really need to be scraping for obscure sources. Regards, Looie496 (talk) 16:51, 9 December 2011 (UTC)
There are many articles that document brain damage, but you have to find them. Why is anesthesia used during ECT? Because some form of damage is going on. Thats why we feel the sensation of pain. http://www.wildestcolts.com/psych_opp/d-electroshock/1-shock.html has some references I hope to add to balance out the "goodness" of ECT.--Mark v1.0 (talk) 22:50, 31 January 2014 (UTC)
Removed badly written and un-sourced content
I removed the following text from the "Administration" section.
- Informed consent is sought before treatment. Patients complain usually after the fact, that there was no truthful informed consent given. Databases collected over the years show this, ect.org has one, but there were others collected in previous decades. Perhaps the most troubling claim is that the current is actually higher, so ECT may be far more dangerous on the brain itself, which contradicts the claim that ECT is "highly safe." One can easily conclude that with enough shocks, and given the seizure threshold becomes more difficult to surpass, requiring often, higher doses of current to induce the seizure, ECT's cummulative damage in of itself, warrants it a brain damaging procedure. The ECT of "yesteryear" was routinely thought of as barbaric, brain damaging by top neurologists. So one huge question is if electircity is the same, or higher, how is it possible that ECT is at all safe, given the numerous anecdotal horror stories of memory loss, especially with increased frequency of shock. To further confound the debate, there is no talk of the actual voltage, current, or possible risk of any long term cognitive impairment, when many report permanent memory loss, sometimes up to a decade or more of autobiographical memory loss. There is also the troubling issue of court ordered or "forced ECT," survivors like Leonard Roy Frank have spent his life advocating against his forced 40 shock treatments that he believes destroyed his memory, personality, and caused life long trauma, and cogntiive diability, despite fighting to expose the utter misinformation, and coercion of this industry.
- Patients are also made aware of risks and benefits of other treatments and of not having the procedure done at all. Depending on the jurisdiction, the need for further inputs from other medical professionals or legal professionals may be required. ECT is usually given on an in-patient basis.
The article would be improved with a section discussing the possible placebo effect of its use and comparison with other ghastly medical procedures such as bloodletting. Without knowledge of its mechanism, ECT efficacy is dubious at best. Galfromohio (talk) 18:51, 30 June 2012 (UTC)
Unreferenced paragraph removed
I've removed the following unreferenced paragraph. It seems to be pushing a particular point of view and the claim that "ECT has also been lumped in the same categories as lobotomy and insulin comas, which are now universally regarded as dangerous and a form of torture" is particularly problematic and runs contrary to the rest of the article. Note also that I've removed the link to the ECT stories - the link was broken when I tried to access it.
- Recent studies question if the risks of ECT outweigh any benefits mostly due to accounts of persisting memory deficits in former patients. There is also great concern over claims that the voltage and current is actually higher than in the days when ECT was considered a very dangerous treatment by most mainstream psychiatrists. ECT has also been lumped in the same categories as lobotomy and insulin comas, which are now universally regarded as dangerous and a form of torture. However, many survivors have reported severe cognitive problems including unexpected memory loss, numerous reports of years of life memories "washed away." Some reports and studies show patients losing a decade or more of memory (retrograde amnesia), and inabilities to retain new information, including loss of simple cognitive skills. There may be a huge disconnect over what the ECT industry calls a "highly safe and effective procedure" (claiming memory loss occurs only around the time course of treatments), and what many former patients report as a "memory eraser," a term frequently used by "bad outcome" ECT stories. Lack of truthful informed consent has also been a key issue troubling those patients, as well as doctors, who question the basic ethics behind ECT. Some personal accounts tell of devastation due to cognitive loss of former ECT patients. Julie Lawrence 2007 Personal ECT Stories HealthyPlace
POV and weasel words
i dont know how to make the cool markings that indicate a wiki principle needs attention. i added a wiki pov note to the sarcastic bit about the surgeon general and 'gross' damage. it's a medical term and explanation is warranted (thus i did not remove the sarcasm.)
the weasel words "small minority" are used in the first paragraphs about ect in other countries. if there isnt a citation i'm not sure where this comes from, though i am entirely willing to believe it. :-) Tkech (talk) 23:25, 6 March 2012 (UTC)
Carol Kivler testimonial and mechanism of action
I have removed new content on the mechanism of action and an endorsement from Carol Kivler. Medical content on Wikipedia is strictly governed by guidelines and policies. I'm not sure the Kivler testimonial, or any testimonial, is appropriate for an evidence-based article. A very important guideline is Wikipedia:Identifying reliable sources (medicine). The source (Perrin et al.) for the mechanism of action content does not conform to that guideline.
Perrin et al., an fMRI study of ECT and frontal cortical connectivity in severe depressive disorder, is not appropriate for the claims the new text makes. Per the guideline I linked to above, we rely on expert reviews to put such results into context. This study can be mentioned once a review has done that, if the review gives it sufficient importance to warrant inclusion.
Also, it's important to be very precise in paraphrasing sources. The recent edit said, "The group's findings confirmed the hyperconnectivity hypothesis of ECT" which is stronger than the source's "The findings reported here add weight to the emerging “hyperconnectivity hypothesis” in depression..."
I'm not contesting the veracity of any of the content. But to be included in Wikipedia, the relevance and accuracy of all medical content must be supported by sources that conform to the above guideline - usually systematic reviews, graduate-level textbooks, national or international professional guidelines, or similar, that can be expected to accurately reflect the current scholarly consensus. --Anthonyhcole (talk) 07:41, 7 April 2012 (UTC)
Rollback of edit to "There is a significant risk of memory loss with ECT"
I used the rollback feature to change the last edit which added the word temporary to the following sentence: "There is a significant risk of temporary memory loss with ECT". I wanted to revert because that is not supported by that source - they emphasise, rightly or wrongly, permanent memory loss. I should have reverted the edit rather than use the rollback feature, however. FiachraByrne (talk) 22:04, 1 November 2012 (UTC)
Actual examples should be removed
The topic says that "In 2012, CNN revealed a video of Andre McCollins at the Judge Rotenberg Center Center for behavioral therapy in Canton, Massachusetts being subjected to Electroconvulsive therapy. The 18 year old boy's mother described Andre as being "tortured, terrorized and abused" by this type of treatment." This topic should be removed since it is not a video with an example of electroconvulsive therapy. If you go to the CNN reference in youtube (reference 145), Anderson Cooper states very clearly that it was a case of "aversive therapy" using SKIN SHOCK. So, again, nothing to do with electroconvulsive therapy, watch it at about two minutes of the video.  (Francisco) — Preceding unsigned comment added by Fguarn (talk • contribs) 18:26, 13 November 2012 (UTC)
"A 2011 paper in the Journal of Psychiatric Nurses Association reported that ECT was effective."
I can't access the article without paying for it, so I can't confirm that the paper actually supports ECT. In light of this problem, should the paper be cited at all?— Preceding unsigned comment added by Sonicsuns (talk • contribs)
- Our sourcing policies don't require that free online versions of sources be available -- it's always good if possible, but often would mean that essential and highly reputable sources could not be used. In this case, though, that appears to be a very short opinion piece that doesn't really add anything of substance to our article, so I would be supportive of removing that line if that's what you would like to do. Looie496 (talk) 21:20, 19 March 2013 (UTC)
- I think that is a strong and important statement. I don't think it should be removed. And yes, unfortunately this is a problem and WP:PAYWALL says that wikipedia does not guarantee ease in accessing sources. MidnightRequestLine (talk) 01:34, 20 March 2013 (UTC)
I hope an editor will make corrections to the "administration" section.
A few basic points: ECT is a treatment for severe episodes of major depression, mania, and some types of schizophrenia. No changes in medication are made prior to beginning treatment, with the exception of benzodiazapenes. Benzodiazapenes can interfere with the efficacy of ECT, so a patient may be tapered off prior to beginning treatment. However, if this will be counter-therapeutic, a benzodiazapene antagonist can be used at each ECT session. ECT is usually administered three times a week, on alternate days, over a course of two to four weeks. It is administered under general anesthesia, after which a muscle relaxant is given to control the seizure activity (the only seizure activity to the body is a clenching of the jaw, and a twitching of the foot [a tourniquet is placed around one ankle prior to the administration of the muscle relaxant]). The patient's EEG, ECG, and blood oxygen levels are monitored during treatment. The controlled electrical stimulus lasts from a fraction of a second to a maximum of six seconds. Over the past decade, unilateral ECT has overcome bilateral ECT as the treatment of choice, because it is associated with significantly less memory impairment.
- Thanks for pointing out that the article could use more detail in this section. However for information of this nature to be added to the article, it must be supported by a published, reliable medical source, as per the WP:MEDRS guideline. The source provided is not useful in that regard. I will do some digging for sources and see what i can find.Jytdog (talk) 00:01, 25 March 2013 (UTC)
- source gathering. First line is handled in "patient selection" section, not in administration section.
Snd line. Apparently there is little consensus on whether meds should be tapered or maintained. :1885 As for reducing benzos, that is clinical practice, as is potentially administering a benzo antagonist, :1879 as benzos increases the seizure threshold, but apparently the ECT treatment given can also be adjusted to compensate for that.:1875 anesthesia and muscle relaxant are already covered in the administration section. duration of a given treatment, their frequency and duration of treatment overall are discussed here :1882-1883 as is monitoring. location of electrodes is as you say:1881. OK I will add this content to the article with these sources. Thanks again for the suggestion. — Preceding unsigned comment added by Jytdog (talk • contribs) 00:46, 25 March 2013 (UTC)
- Rudorfer, MV, Henry, ME, Sackeim, HA (2003). "Electroconvulsive therapy". In A Tasman, J Kay, JA Lieberman (eds) Psychiatry, Second Edition. Chichester: John Wiley & Sons Ltd, 1865–1901.
- Haskett RF and Loo C (2010) Role of Adjunctive Psychotropic Medications during ECT in the Treatment of Depression, Mania and Schizophrenia J ECT. 2010 September; 26(3): 196–20
section of text for deletion
I was just reviewing the article for violations of WP:OR and was also fixing some citation needed tags when I came acrss this:
"There are recent animal studies that have documented significant brain damage after an electroshock series. For example, in 2005, Russian researchers published a study entitled, Electroconvulsive Shock Induces Neuron Death in the Mouse Hippocampus: Correlation of Neurodegeneration with Convulsive Activity. In this study, the researchers found that after an electroshock series, there was a significant loss of neurons in parts of the brain and particularly in defined parts of the hippocampus where up to 10% of neurons were killed. The researchers conclude that "the main cause of neuron death is convulsions evoked by electric shocks." In 2008, Portuguese researchers conducted a rat study aimed at answering the question of whether an electroshock series causes structural changes in vulnerable parts of the brain. According to the authors, "This study answers positively the question of whether repeated administration of ECS seizures can cause brain lesions. Our data are consistent with findings from other animal models and from human studies in showing that neurons located in the entorhinal cortex and in the hilus of the dentate gyrus are particularly vulnerable to repeated seizures." However, they question the applicability of their own research with respect to Electroconvulsive therapy in humans: "An important caveat of our results is that it is unclear to what extent they are relevant to the use of electroconvulsive therapy in psychiatry, because the protocol employed in this study is different from that used clinically. Evidence from previous studies (Gombos et al., ; Vaidya et al., ) and from our pilot experiments indicates that treating rats either with five to ten widely spaced ECS (at 24- or 48-hr schedules) or with two stimulations only 2 hr apart does not lead to loss of hippocampal neurons"."
So, this should be deleted under WP:MEDRS. The content immediately above this part, discusses results in HUMANS describing both negative and non-negative effects on brain structure. The sources cited above are reviews. What we have here, are primary studies in animals, that are added together to lend extra WP:WEIGHT to the negatives side. This violates WP:MEDRS and should be deleted. I intend to do so, but because this is a big chunk I wanted to give folks a chance to comment.Jytdog (talk) 00:22, 26 March 2013 (UTC)
- Agreed, and after four days without objection, I have removed it.
Zad6814:09, 29 March 2013 (UTC)
Mechanism of Action
The mechanism of action section is terribly written. Whilst it is true that the definitive mechanism isn't known, there are several promising theories, which the section makes no mention of. Changes in serotonergic neurotransmission (e.g. 5-HT1A receptor increases'reductions), dopaminaminergic neuortransmission (Increases in HVA levels in CSF, decreased D2 receptor binding, increased D1 and D3 receptor binding), neurogenesis (BDNF and VEGF, and BrdU studies of neuorgenesis in animals). I don't know how to write stuff on wikipedia, but for someone who does, please look at recent(ish) reviews on the topic: The use of MST and ECT in Treating depression, ebmeier & Allan international review of psychiatry 23(5): 400-412 (2011). Merkl, A. et al. Antidepressant electroconvulsive therapy: mechanism of action, recent advances and limitations. Experimental neuorology 219: 20-26 (2009). Scott, A. Mode of action of electroconvulsive therapy. Advacnes in psychiatric treatment 17: 15-22 (2011).
- Our articles on academic topics are in general very underdeveloped, so don't expect anybody to come along and do this. You should feel free to edit the article, or if you would like to suggest specific changes here on this talk page, I would be happy to react to them. Regards, Looie496 (talk) 15:51, 8 April 2013 (UTC)
Needed Citation in Adverse effects: Effects on memory
I suspect that the source for the Sackeim reference that has been marked-up "citation needed" is: Sackeim et al 2007, 'The Cognitive Effects of Electroconvulsive Therapy in Community Settings' Neuropsychopharmacology, vol. 32, pp. 244–254 (The full paper can be found for free here: http://www.nature.com/npp/journal/v32/n1/pdf/1301180a.pdf)
The uncited text in this section is a little vague and unencyclopedic but its substance appears well-sourced. Again, I can only speculate but it looks like the Wikipedia editor was trying to paraphrase the conclusion that appears on page 252 of the paper. Hope this helps. 126.96.36.199 (talk) 07:33, 11 April 2013 (UTC)
The introduction paragraph has gone throught quite some re-edits. The latest change can be seen here: http://en.wikipedia.org/w/index.php?title=Electroconvulsive_therapy&diff=572065183&oldid=570438334
The following is the disputed insert which is highlighted by bold: Electroconvulsive therapy (ECT), formerly known as electroshock, is a controversial psychiatric treatment in which seizures are electrically induced in anesthetized patients for symptom remission. Its mode of action is unknown. Its efficacy has been questioned, with some meta-analyses illustrating a statistically significant, and positive, effect of the procedure while others suggest the procedure is no more effective than a placebo (see discussion following). The use of electroconvulsive therapy evolved out of convulsive therapy. Long before electric shocks were being administered to induce seizures, doctors were using other drugs and methods to induce seizures as a means of treatment for severe depression and schizophrenia. Today, ECT is used as a treatment for clinical depression that has not responded to other treatment, and sometimes for mania and catatonia. It was first introduced in 1938 Italian neuropsychiatrists Ugo Cerletti and Lucio Bini, and gained widespread popularity as a form of treatment in the 1940s and 1950s.
False gender gap removed
The first sentence of History currently reads "As early as the 16th century, agents to induce seizures were used to treat psychiatric conditions". There are much earlier uses: there are well-attested records from the classical era by Pliny and Largus of physicians directing patients suffering from epilepsy or other conditions to touch electric rays in the hope of a cure. —BillC talk 10:05, 15 February 2014 (UTC)
Section mentioning Dr. Peter Breggin is biased
The section mentioning Dr. Peter Breggin is extremely biased and misleading. First of all, Dr. Breggin is not a critic of evidence-based psychiatry at all. One of his main points of criticism is that ECT has never had any evidence for its efficacy. There has never been a study comparing ECT with placebo that showed any benefit beyond 4 weeks. Dr. Breggin criticizes the use of ECT because of its lack of evidence. So to say he is a critic of evidence-based medicine is misleading and meant to bias the reader against his views. Finally, the statement that the scientific consensus does not agree is nothing more than an appeal to authority. The citations at the end of that sentence do not support this statement. The most comprehensive review of ECT can be found here: http://www.power2u.org/downloads/1012-ReadBentallECT.pdf.
Cancer and ECT
The Author wrote: that ECT could be administered; but,"with caution in those whose cancers are in remission or under control". I was curious if the Author could provide a reference for this? A friend took more than 10 ECT treatments and underwent a colonoscopy during her "treatment" only to find out she had a tiny cancer growing in her colon (like 3-5 mm in size). She informed her ECT "doctors" of her condition; they were sorry she had cancer; but, showed little concern for any possible interaction with ECT. She underwent one or two more "treatments" and when they resectioned her colon soon after, her surgeon discovered that her cancer had spread to her lymph nodes afterwhich she had to suffer with chemotherapy. Is this a coincidence or did her tiny cancer just randomly enter her lymphatic system? Even her oncologist characterized her cancer as "strange". 188.8.131.52 (talk) 17:16, 24 March 2014 (UTC)
- Sorry about your friend. interesting question about our article. you make a good point that the current text is not supported by any reference. I did some digging and as near as I can tell, the only kind of cancers relevant to ECT are brain cancers - they are a contraindication. I've corrected the text. Jytdog (talk) 17:34, 24 March 2014 (UTC)
10.1 Fictional Examples. A Beautiful Mind inaccurate
Tplew1 (talk) 01:42, 3 April 2014 (UTC) 10.1 Fictional Examples has the movie A Beautiful Mind listed. ect is not shown in this film. insulin shock therapy is shown. Tplew1 (talk) 01:42, 3 April 2014 (UTC) Done, thanks! Jytdog (talk) 02:03, 3 April 2014 (UTC)
POV takeover of page- needs work being restored to NPOV
Hope people see this, the sections on adverse effects, efficacy, controversy over long term effects are all extremely biased, and deliberately any sources that are not pro ECT like "Journal of ECT". — Preceding unsigned comment added by 184.108.40.206 (talk) 02:13, 13 May 2014 (UTC)
- 220.127.116.11 you are clearly new to Wikipedia. You need to be more specific, and back up what you say with reliable sources, as we define reliable sources at Wikipedia. Please read WP:VERIFY and WP:MEDRS. This is not a forum to discuss views on ECT - this is a page to discuss improving the article, according to Wikipedia's policies and guidelines. I don't intend to be mean, but there is a rational foundation for what we do here. 02:33, 13 May 2014 (UTC)
- OK, why is research like Peter Breggin and Harold Sackheim nowhere to be found in the article? Here's his wikipedia entry. http://en.wikipedia.org/wiki/Harold_A._Sackeim As you can see, he's not some schmuck, and is actually a proponent of ECT. Could we please consider mentioning his 2007 research under the Adverse Effects section? — Preceding unsigned comment added by 18.104.22.168 (talk • contribs) 07:17, 13 May 2014 (UTC)
- above, i asked you to read WP:MEDRS. What that says, is that we don't use what we call "primary sources" in health related articles; we rely on reviews and statements by major medical and scientific bodies. btw, if you look at the section on adverse effects on memory and the conclusions of the 2007 primary source you cite, you will see that reviews have absorbed Sackheim's findings and that those findings - that sine wave stimulation and bilateral electrode placement were both associated with bigger problems - are in the article.Jytdog (talk) 11:51, 13 May 2014 (UTC)\\
Negative patient reports
Numerous patients have reported that they feel, rightly or wrongly, that they were damaged, sometimes severely, by ECT. There is one book published by Rutgers University Press, and another by Random House, on this topic. They do not purport to be giving medical analysis; they are reporting their own experiences. (The authors themselves received ECT.) Wouldn't it be more honest to mention these books and say what is wrong with them, if in fact they are defective? Why are negative patient reports not allowed? The following were removed after I added them: Prof. Linda Andre, "Doctors of Deception: What They Don't Want You to Know about Shock Treatment," Rutgers University Press, 2009, ISBN: 0813544416 Jonathan Cott, "On the Sea of Memory: A Journey from Forgetting to Remembering," Random House, 2005, ISBN: 1400060583 "The Electroshock Quotationary," ed. Leonard Roy Frank, 2006, http://endofshock.com/102C_ECT.PDF, retrieved 2014-08-17 "ECT = Intentional Brain Damage," The Experience Project, http://www.experienceproject.com/stories/Have-Had-Ect/914469; retrieved 2014-08-17 The last two are from less verifiable sources, but that people are making these comments alarm me. That they cannot be mentioned in the article alarms me more.deisenbe (talk) 02:40, 18 August 2014 (UTC)
- If negative patient reactions to the treatment are indeed a significant complication of the treatment, that will be reported in the secondary literature and can be included here. We cannot possibly include mention of every individual who came away with a negative view of the treatment, just like we cannot possibly include mention of every positive story. Blogs and self-published materials like essays are primary sources for the views of the authors and secondary sources would be required to establish that the use of those primary source complies with WP:WEIGHT. The article already has a large section on adverse effects (although the sourcing could be improved) including memory loss and brain structure, please read through that and see if your concerns aren't already covered in the article.
Zad6802:10, 18 August 2014 (UTC)
- Deisenbe please assume good faith. We are a community made up of lots of different kinds of people which means there are disagreements. We talk them through. Please change the section header. thanks. Jytdog (talk) 03:14, 18 August 2014 (UTC)
- :) Thanks for changing that. Yep, people say lots of things and importantly, experience a lot of things. But we want this article to be science-based, not anecdote-based. So we rely as much as we can on statements by major medical and science bodies (Like the NIH in the US or the NHS in the UK) or by good reviews published in the scientific literature. Those kinds of sources help us get as close to "truth" at any given time as we limited humans can... thanks again for talking. Jytdog (talk) 04:21, 18 August 2014 (UTC)
Use of uncommon words
I have changed the word "efficacious" to the word "effective". It is only a minor edit but I think this could be an indication that there may be other issues like this within the article. There was also the word "efficacy" but I left that in.
Wikipedia is supposed to be wide reaching. I am of the school of thought that says that commonly used words should be used where possible in any informational writing.--Hypernator (talk) 19:06, 29 September 2014 (UTC)
- I came back to this because I felt that I had used an insufficient word replacement. Instead of replacing the word "efficacious" with the word "effective" I have expanded the sentence. I have now written the whole dictionary definition for the word efficacious into the sentence. It is not too long but, most importantly, it makes it far easier for a layperson to understand what is being said now. The word "efficacious" does not seem to be commonly used.--Hypernator (talk) 15:42, 2 October 2014 (UTC)
I wonder if this article is sufficiently balanced? I'm no Wikipedia expert but it generally reads as very pro-ECT. Any evidence which does not support the use of ECT is buried in the middle of sections. And the 'Controversy over long-term effects on general cognitiion' section has barely a mention of opposition to the view that ECT is safe and effective. I think Read and Bentall's review could be mentioned again here: http://www.ncbi.nlm.nih.gov/pubmed/21322506
I'm not advocating a complete overhaul of the page, I thought it was an interesting read. However, the tone of positive certainty left me feeling uneasy. Psychiatry has a chequered history, having evolved over the years through a lot of trial and error. Although there are a range of useful ideas and treatments it is important not to fall for the lure of simple answers, when the evidence base shows mental health is far from simple.
- The specific concerns you are bringing up deal with how much WP:WEIGHT or emphasis to give to each viewpoint. In this case, any discussion about "pro" or "anti" anything needs to be sourced to reliable sources, in this case our guideline for medical sources for medical claims. If the majority sources are "pro" ECT, then we are too. We do not give equal validity to all positions. I do not like criticism sections, and prefer that any critiques be incorporated into the article. Yobol (talk) 17:31, 4 December 2014 (UTC)
Alleged copy vio
I put in the following:
 In 1785, the therapeutic use of seizure induction was documented in the London Medical Journal. As to its earliest antecedents one doctor claims 1744 as the dawn of electricity's therapeutic use, as documented in the first issue of Electricity and Medicine. Treatment and cure of hysterical blindness was documented eleven years later. Benjamin Franklin wrote an electro static machine cured "a woman of hysterical fits." G.B.C. Duchenne, the mid 19th century "Father of Electrotherapy," said its use was integral to a neurological practice.
In the second half of the nineteenth century, such efforts were frequent enough in British asylums as to make it notable.
- A History of Mental Institutions in the United States which says electrostatic machines were used in 1773
- Electroconsulsive Therapy – A History using date of 1746
- Rudorfer, MV, Henry, ME, Sackeim, HA (2003).
- Wright, Bruce A. M.D. "An Historical Review of Electro Convulsive Therapy". Jefferson Journal of Psychiatry: 66–74.
- Beveridge, A. W.; Renvoize, E. B. (1988). "Electricity: A History of its use in the Treatment of Mental Illness in Britain During the Second Half of the 19th Century" (PDF). British Journal of Psychiatry: 153, 157–162. Retrieved 28 December 2014.
- thanks for removing the copyvio from this version of your edit. Jytdog (talk) 19:04, 28 December 2014 (UTC)
edit warring over content based on outdated review
IP editor 22.214.171.124 added content based on an old review, which I removed on the basis of MEDRS, as our article already cites newer reviews. The IP editor has been re-inserting it, not providing a response to the violation of the guideline, for example here: dif. Per WP:BRD the burden is on the IP address to open a discussion. I have gone ahead and done it. IP, please explain how the content you want to add is OK per WP:MEDRS. Thanks. Jytdog (talk) 17:12, 16 February 2015 (UTC)
ECT mania addition
I think it is critical to indicate that ECT should only be used to treat mania AFTER at least one trial of psychotherapy has been conducted. — Preceding unsigned comment added by Ahuelsman (talk • contribs) 19:46, 29 March 2015 (UTC)
Edits under "Usage"
Electroshock therapy has mass versatility and is performed on approximately 100,000 people a year. Although it is more common in older patients and in women, it has the capability to be used across all age spectrums, including in children. In addition, it can also be administered to pregnant women who can't take anti-depressants and to patients who have serious medical problems/illnesses. ECT has the vital function of getting people who are acutely suicidal out of that desperate state 
References ^ Fawcett, Kirstin., "Electroconvulsive Therapy: What it is, How it Works and Who it Helps." U.S. News Health, October 29, 2014.
These changes will make the eliminate the original first line under "usage" and make it sound more scholarly and increase clarity. It will also add the broad overview of the usages of ECT in women, wide age spectrums, and patients with medical problems; this is gone into more depth in the sections "United states" etc. but would be useful in the usage section. The addition of the concluding sentence is also new information that is key to include under usage. Lewilson95 (talk) 20:04, 29 March 2015 (UTC)
- that source fails WP:MEDRS - we cannot use it for content related to health ( like what ECT can and cannot be used for) Popular media is OK for some things, as described in the section on that in MEDRS. Jytdog (talk) 20:20, 29 March 2015 (UTC)
Can we please add a header photo? One that might show a person enjoying the procedure? All the pictures we have so far are historical, but it would be nice to see this topic further developed with a simple picture at the top of the page. I'd like for somebody looking into this therapy article to see that it is a modern procedure and that it is not as scary as the current historical pictures depict. — Preceding unsigned comment added by Kjk5182 (talk • contribs) 20:48, 5 April 2015 (UTC)
- I very much doubt that anyone 'enjoys' ECT. And as for a picture, even if one were available (we rely on volunteers uploading images, and can't simply produce them on request), there are clearly issues of confidentiality involved in showing someone undergoing a psychiatric procedure - per the Wikipedia:Image use policy we would require the consent of the individual before using such an image. AndyTheGrump (talk) 21:07, 5 April 2015 (UTC)
- I would consent as the subject, but when I asked for permission to have myself photographed undergoing ECT, my request was denied by the hospital legal department due to "liability issues". Since the procedure would involve at least 5 individuals besides myself (an anesthesiologist, their assistant, a doctor, a nurse, and of course a photographer) whose consent would also be required, I assume that they expect more than a simple verbal request. I have neither the expertise nor motivation required to write a legally binding document protecting the confidentiality and liability of all involved, but if someone were to contact me with a link to an appropriate public domain document that could be filled out by myself and others then presented to hospital legal staff, that might be enough. I agree that a more accurate and contemporary photo would improve the article. In my experience it is not as visually striking of a procedure as one might imagine, most closely resembling the typical use of general anaesthesia with ventilation provided via ambu-bag instead of intubation (or as I personally describe it, "like surgery, but without the surgery"). - Syd (talk) 21:07, 21 April 2015 (UTC)
Additional famous persons
I believe the 'Famous cases' section needs a bit more information in order to provide readers with sufficient information. A very notable person who has undergone ECT is Sherwin B. Nuland, award-winning author and surgeon.  Kyliempaul (talk) 01:30, 19 April 2015 (UTC)kyliempaul
- Personally, I can see little merit in a 'famous persons' section at all - it can only ever consist of random anecdotes. AndyTheGrump (talk) 01:51, 19 April 2015 (UTC)
I think since ETC is such a misunderstood topic (due to portrayal in film), including famous persons who have undergone ETC would be beneficial. I know when I first read the article, I found the 'Famous cases' section to be very interesting.Kyliempaul (talk) 14:32, 19 April 2015 (UTC)kyliempaul