Talk:Electroconvulsive therapy

Controversy

From the article:

Controversy also stems from the fact that many leading proponents of the treatment hold financial interests in the companies which manufacture ECT equipment.

Really? Evidence please. The Anome 23:56, 16 Mar 2004 (UTC)

I would have thought that most of the leading proponents would be psychiatrists who have personally observed the benefits of administering ECT and that most psychiatrists wouldn't even know who manufactures ECT machines. It is not as though ECT machine manufacture is a huge industry. Each psychiatric unit would have one that they keep for maybe 10 years before they update them. Since there has been no response to the above comment I have removed this sentence. --CloudSurfer 19:58, 12 Sep 2004 (UTC)

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Actually, the leading proponents are psychiatrists who earn a hefty fee every time they flick that switch. On our local psych ward, the machine was manufactured by an outfit called Somatoform, but I have no information on that company. -- EFS

It is also used in countries without a per-session fee, so I'm not sure if you are correct about this assertion. JFW | T@lk 20:42, 15 August 2005 (UTC)

Good point - I'm sure it varies world-wide. In British Columbia, however, a physician bills the Medical Services Plan for each electroshock. And North America is experiencing a resurgence in electroshock. -- EFS

In the Ontario city where I'm a psychiatry resident almost all the psychiatrists are salaried. As a result though they all refer patients for ECT and all believe in it's effectiveness they all prefer not to be the one to carry out the procedure since it involves arriving in the hospital at a fairly early hour and the work itself it somewhat boring and repetitive (check vitals, flick switch, observe convulsions, record info, repeat) djheart 06:11, 2 December 2005 (UTC)

Sounds boring, all right. Too bad they don't stick around for the fun afterwards, like having family members have to explain to the patient where she lives, or her husband's name, or why she's in the hospital, etc. time after time after time. Psychiatrists sicken me. The whole field needs to be turned upside down. Francesca Allan of MindFreedomBC 03:27, 3 December 2005 (UTC)

The attending psychiatrist for the patient is around afterwards for the follow-up, frequently however the psychiatrist performing the ECT is not the same as the one following the patient on the wards since as I said before psychiatrists usually take turns doing the ECT and will do it for all the patients scheduled for the morning. djheart 01:48, 5 December 2005 (UTC)

Same around here. Different psychiatrists act as the shock doctor week to week. However, they are paid for their "services" by the Medical Services Plan. As for the initial terror and confusion experienced by the patient upon awakening, that is mostly missed by the treating psychiatrist who typically sees the patient on the ward later that day. Francesca Allan of MindFreedomBC 06:18, 5 December 2005 (UTC)

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WHO DELETED MY LINK TO AN EXCELLENT REFERENCE,DR. PETER BREGGIN'S PAPER ON ELECTROSHOCK? AND WHY? -- EFS

EFS, I don't think shouting will get you anywhere and the rationale has been explained (withdrawn Ft. Jack Hackett 12:55, 19 November 2005 (UTC)).. --81.179.80.131 15:40, 17 November 2005 (UTC)

Where has the rationale been explained? I'm curious as to what the rationale could be for deleting references that pro-psychiatry editors happen not to like. Francesca Allan of MindFreedomBC 16:19, 17 November 2005 (UTC)

Excerpts from one of Breggin's books on his web-site appear to state something to the effect that in whoever thinks ECT helped him/her this is automatically an expression of iatrogenic denial and helplessness (he does endorse the fact that many ppl think they benefited from ECT). Also, that serious risks associated with a certain treatment preclude its use. If all of this was true, scientific research, rational thought and all of medicine and surgery are folly and should be abolished, because they are not viable methods to gain knowledge and potentially put ppl in harms way respectively. Tell this to your surgeon when he has you in theater for trauma-surgery (<--- potentially life-threatening in itself), god forbid. Consider the ad-hoc-ness of the first statement: such an expression _cannot_ be argued against. It is a way of trying to _immuninse_ an argument against criticism. See Karl Popper's works for in-depth discussion of this. However, I have not yet read the article nor the book in full. But as the excerpts appear hand-picked by the author they may very well be representative. Ft. Jack Hackett 13:44, 19 November 2005 (UTC) PS: BTW, I didn't delete the reference. Oh, and EFS, please stop using all-caps: its irritating.

So you don't like one of Breggin's books (which apparently you haven't even read except for an excerpt posted on his website) and therefore we can't have a link to his excellent and relevant article posted here. Please explain this IN A WAY THAT MAKES SENSE, please, and stop being a wiki-bully. Francesca Allan of MindFreedomBC 03:46, 2 December 2005 (UTC)

By the way, you're misquoting and misunderstanding Breggin above. Try not to sneer at what you don't understand. It's unbecoming. Francesca Allan of MindFreedomBC 03:48, 2 December 2005 (UTC)

You're out of line, Ft. Jack Hackett, and I've asked an admin to come over and take a look. Francesca Allan of MindFreedomBC 03:57, 2 December 2005 (UTC)

I can't believe your arrogance. You haven't even read the article but you decided it doesn't rate and so you made a substitution. The Breggin article is now back in. Please stop and take a moment to consider your actions before destroying other people's work. THANK YOU. Francesca Allan of MindFreedomBC 04:24, 2 December 2005 (UTC)

Hi, Francesca. Just to get the facts straight: I have _never_ edited the actual article on ECT. That means as well that I _never_ have taken out the link to any of Breggin's works/websites. I, for one, would even _agree_ to have his works/websites linked to in the ECT article, because I believe in representing _all_ sides on potentially controversial topics. And, believe me, Francesca, I know, that ECT is a really very controversial topic, and should not be considered lightly. I have to stress that the above lines were just to give my personal opinion (POV) on Breggin's works. This I did in the hope to maybe explain why someone should have taken out the link to his works, which I, as you _and_ I rightly point out, I haven't even read. (Still, I am convinced, that I do not need to read all his work to be entitled to have a personal opinion about it). And, again: I have _no_ doubt that a link to his works would be just and even helpful. I just thought, I'd mention this, because sometimes we are too quick at having a fixed opinion about a situation without getting the facts correct first. Take care, and all the best for the festive season and the New Year... Ft. Jack Hackett 23:22, 29 December 2005 (UTC)

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Overall, this is a very excellent article, but two sentances in it struck me as widely exaggerated, if not completely inaccurate. As far as I know, neither of these are true, so I felt compelled to stick them here. I'd like to see some evidence (I'm next in line behind The Anome) before they go back in the article.

"...and may remain mentally dull and listless for hours, days, or even weeks afterwards - see side effects below."

"Repeated administration of ECT produces dramatic long term changes in personality and mood, along with increasingly diminished memory function."

Defenestration 10:03, 20 Mar 2004 (UTC)

Maybe you can find some evidence here: Retraumatizing the Victim or here: Case Reports: Restraint Deaths & Abuse (I think most cases of psychiatric "treatment" could be subsituted by early recognition (e. g. by some kind of auditing) of the precursors of so called insanity). --Riddick 23:33, 29 Sep 2004 (UTC)

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Kwertii, I'm sorry, but I can't agree with some of these changes. There is a small subset of previous patients that now speak out against ECT, as you mention, and appropriately, the article mentions them (in several places). However, their view that ECT does nothing but kill brain cells is not taken seriously within the medical community; ECT has been studied for years, and although they still don't understand exactly how it works, there is absolutely no evidence of brain damage or neuron death. I strongly feel that, while they should be mentioned in the article, it simply has no place in the first paragraph. I understand your concern about representing the other side fairly, but first and foremost we should be representing the truth. Defenestration 07:07, 1 Apr 2004 (UTC)

"Opponents claim that ECT's only mechanism of action is through causing the death of brain cells."

For all the reasons mentioned above, I have decided to remove this sentence. I didn't agree with many of Kwertii's changes, but this was the worst of them. The rest, I can live with. For now, at least. Defenestration 06:27, 6 Apr 2004 (UTC)

I could think of a conditioning-like effect, because some opponents of death penalty by electrical current (electrocution) claim, that low-level operation centres (remember: according to Church of Scientology N2O anaesthesia does not shut down the whole brain function; remember: at least one anaesthesist in F.Rep.Germ uses local anaesthesia together with full anaesthesia during belly surgery) in the brain are triggered by the current, so that the brain feels fear, which could explain the calm behaviour afterwards (after they (nearly) feared to death)). --Riddick 23:33, 29 Sep 2004 (UTC)

I have seen alltogether two completely black cars in front of the entrance of two different psychiatric facilities; one of those cars was loaded with a cadaver box (of course death might be caused by suicide, too; of course somebody might have called those cadaver-care-people wrongfully (but it was not me)). --Riddick 23:33, 29 Sep 2004 (UTC)

I would like to know, why psychiatrists do not look as close as possible for the cause of the "insane" behaviour; the Church of Scientology tries to propagate such procedures since 1950 without any real success (as far as I know; I wonder why that is). --Riddick 23:33, 29 Sep 2004 (UTC)

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I have a relative who had ECT about a year ago. He didn't have any issues with receiving it, and had no problems afterwards. Defenestration commented on 20 Mar 2004 about two lines about ECT that said that people who received it remained in a dull and listless state for a long time after receiving ECT. He also commented on the line about ECT changing personality and mood, and the effects on long term memory. Based on what my relative said, neither of those were true, at least for him. He was groggy from the anestetic for a few hours afterwards, but didn't have any problems with dullness or listlessness after the stuff wore off. He said some of his memories around that times that he had ECT aren't very good, but that ECT hasn't really done any damage to the memory.

JesseG 03:23, 17 Jun 2004 (UTC)

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JesseG, with respect, the fact that you know of ONE person who wasn't harmed isn't much reassurance. I know of HUNDREDS of people who were harmed. -- EFS

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I think that the "controversy links" if they are to exist at all, should include some links to sites that argue in favor of, or are at least neutral about, the use of ECT as a medical treatment. I can't help but notice that every single link in this section currently points to an anti-ECT site. How is something a controversy if there is only one side arguing?

-Rusty 18 Feb 2005

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There is PLENTY of evidence of long-term impairment (including cell death) from electroshock but psychiatry disregards it. I posted a link to a great article on the subject but one of those NPOVers deleted it because it didn't fit with THEIR POV. -- EFS

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WOULD WHICHEVER PRO-PSYCHIATRY CAMPAIGNER IS CHANGING MY EDITS WITHOUT DISCUSSION PLEASE DISCUSS THEM IN THIS SECTION FIRST? WP IS SUPPOSED TO BE NPOV. THUS, REFERRING TO "RATHER VOCAL FORMER PSYCHIATRIC PATIENTS" HAS NO PLACE IN THIS ARTICLE. THERE IS A LARGE MOVEMENT AGAINST ELECTROSHOCK AND OTHER PSYCHIATRIC ASSAULT. IF YOU CONTINUE TO TRY TO MINIMIZE OUR POINT OF VIEW, I WILL GET MORE AND MORE FORCEFUL ABOUT MINIMIZING YOURS. -- EFS

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Removed the following: "The Church of Scientology's Dianetics claims that ECT does not treat the cause of the disorder but suppresses natural reactions to certain influences by creating further disorders (this view should be treated with caution as it seems to lack scientific background.)" Scientology's theories on psychiatric treatment have no place in an article on actual psychiatric treatment. Otherwise, we might as well put "Scientology thinks this is bullshit," in every psychiatric article. 208.210.144.246 05:37, 24 December 2005 (UTC)

Historical Usage

Do we actually know that it was used as a form of punishment? I know some patients have written that it was but do we know that the treatment team at the time used it with that intent. It is more likely that they saw the disturbed behaviour and then decided to treat that with one of the few treatments they had available before the general use of antipsychotic and antidepressant medications. We have to be careful here about the attribution of these sort of things as they are not NPOV unless they can be justified. --CloudSurfer 20:16, 12 Sep 2004 (UTC)

I think it was supposedly used as a punishment for people with Sluggishly progressing schizophrenia in the USSR. This was a disease of political prisoners --MacRusgail 02:41, 11 July 2005 (UTC)

On the contrary, I'm in British Columbia and it is used as punishment. Many psych patients are threatened with it. It's also used as effective coercion: take this drug or we'll have to shock you. -- EFS

You surely are aware that what you're saying is not a statement about ECT itself but rather about a health care individual trying a mean way to cajole a patient into having ECT. BTW have you considered that during cardiac defib a much stronger current is applied to an equally non-regenerating tissue: the human heart. And naturally you wouldn't argue that someone has suggested a feasible better treatment for pulseless VT/VF along the lines of "hey let's wait and see, this is just an expression of environmental influence on the patient so let's not interfere with it." There are patients that are depressed to the point of not being able to get themselves to the toilet and not eating anymore. Depression can be an extremely disabling illness. And I find it quite cynical to push for ECT to become abolished if it in _some_ cases it is the last resort (well-researched) treatment option. And I can assure you that there are patinets who are thankful they were lifted out of life-threatening illness by this treatment. The problem of course being that you resort to evasive/unbacked/ad hoc statements like "you know one who benefited? I know hundreds who didn't.". However, ECT should of course not be taken lightly, and it of course is a somewhat "crude" treatment. But for want of a better researched, comparably efficient and less harmful _last-resort_ treatment for otherwise treatment-refractory severe depression we should be glad ECT is available. --Ft. Jack Hackett 12:42, 19 November 2005 (UTC)

Actually, what I'm saying is that psychiatric patients have their rights violated all the time and being threatened with electroshock is just one example from thousands. Depression is not at all like a heart attack so your cardiac defib analogy just doesn't apply. Patients are lied to about the risks of electroshock and, despite your claims, it is not merely a treatment of last resort -- many psychiatrists push ongoing maintenance electroshock. Why are you saying my claims are "evasive/unbacked/ad hoc"? I've survived electroshock and can speak to its effects. We do have treatment for depression that is more efficient and less harmful but psychiatry isn't interested in it. Francesca Allan of MindFreedomBC 03:21, 3 December 2005 (UTC)

Recent changes and future improvements

I have changed the controversy section to say there is for the most part consensus amongst psychiatrists about ECT. This is certainly my experience from Australia but I truly don't know what psychiatrists in the rest of the world think. The APA position in the US would seem to confirm what I have written but I don't have practical experience of that. I do know that many people who have not had direct contact with the clinical use of ECT see it as barbaric and that includes psychology students and graduates who have not worked in psychiatric hospitals. Please feel free to alter that section but I would ask that you internationalise it with any differences. E.g. "While in some parts of the world there is for the most part consensus amongst psychiatrists about the benefits of ECT, in XXX psychiatrists are in general against its use."

This article has a few references but does not then go on to list them at the bottom. The reader is left with some names and dates and no idea of how to verify or expand on what is said. If anyone has these citations, could they please put them in. --CloudSurfer 17:15, 22 Sep 2004 (UTC)

The section on "Effectiveness" seems to have been copied verbatim from the Surgeon General's report to which the article provides a link at the end... --jcm787s@smsu.edu

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The fact that mainstream psychiatry is all for electroshock isn't very helpful to the debate. BTW, I have had DIRECT contact with electroshock and can tell you first-hand that it is devastating. -- EFS

External Links

Do we want to mention Citizens Commission on Human Rights (CCHR) in the "External Links" section? --Riddick 23:33, 29 Sep 2004 (UTC)

I hadn't really paid much attention to this section of the article. As it stands at the time of this comment, the external links are headed: Pro-ECT, Anti-ECT, Studies in-progress and Others. There are many more links to the Anti-ECT sites, which the CCHR would include. There are major problems here from a NPOV perspective. The article is largely "pro-ECT" and this reflects the scientific consensus which is expressed in the NIMH consensus statement. Personally I think we should have the NIMH and Surgeon general links at the top with the American Psychiatric Association link all under a new heading, e.g. "Medical and consensus links", or no heading at all. Then I think we should have the remaining "Anti-ECT" links under the heading "Controversy". The CCHR, the name of which could mislead people into thinking it a government body, should mention that it is a Scientology site and a link given to that encyclopedia entry for perspective. --CloudSurfer 06:16, 30 Sep 2004 (UTC)

Since the CCHR was just founded by the Curch of Scientology and since the CCHR is not affiliated with (as far as I have been told) the Church of Scientology we should just write that the CCHR was founded by the Church of Scientology. --Riddick 10:14, 30 Sep 2004 (UTC)

A link to the Church of Scientology web site could be appropriate in an alternative treatment section (although I am not sure if there are any real alternatives as soon as the patient shows sufficient symptoms for being treated with ECT; but the Church of Scientology claims, that they can do it even in emergencies). --Riddick 10:14, 30 Sep 2004 (UTC)

I would agree with the redesign of this section. --Riddick 10:39, 30 Sep 2004 (UTC)

The bottom line from a medical research viewpoint is that ECT is the treatment of choice for very severe depression. Once patients (and they are usually patients by the time compulsory treatment is considered) have reached this stage many, if not most jurisdictions allow compulsory treatment with ECT. One of the problems in eliciting informed consent at that stage is that the patient is usually psychotic and their thinking processes are skewed by depressive thoughts. They also often have psychomotor retardation and are either extremely slow to respond or do not respond to discussions about the issues. It is for this reason that most (and I would have thought the vast majority but I don't know this for a fact) jurusdictions in the world allow for compulsory treatment with ECT. Reading the links here should show that the people complaining about ECT represent a minority view. For instance, one site records that one small region of the former Yugoslavia has been the first place in recent times to ban ECT. The article notes that a small number of patients are moved to a neighbouring region that allows it when they need this treatment. The article does not mention the implicit fact that the rest of the world has not banned ECT. The minority view these sites hold does not mean they are wrong just because they are in the minority, but it does mean that the article should not present an inordinate number of views which might be out of balance with the thrust of the text. Most anti-ECT articles provide further links and can act as an entry in to this literature for those who wish to read more. Well, that's my understanding of NPOV anyway. --CloudSurfer 01:00, 1 Oct 2004 (UTC)

• I have heard of psycho-techniques that can cause strange muscle conditions (like: a so called "cataleptic bridge" induced by hypnosis (as shown in some circusses in the U.K some time ago; of course it might be just a trick sometimes...)), so that I am really unhappy with ECT, because: It seems to be possible, to create a certain condition in the patient, so that the M.D is driven to apply ECT with all those possible consequences (brain/memory damage, conditioning, stimulation of bad emotions, etc. pp.), which could be a trick of a certain group of co-citizens (see "rehab pressure" below); it would not be a new feature of humans, as we have seen in mid-age. --Riddick 10:33, 1 Oct 2004 (UTC)

• ECT causes muscle contractions and the newer technique of transcranial magnetic stimulation (TMS) probably does too but I really don't know anything about it. It's not the muscle contractions or even the electrical stimulus that are important, it's the fit that seems to work. --CloudSurfer 17:31, 1 Oct 2004 (UTC)

• I strongly believe, that all other psychiatric symptoms can be simulated by psycho-techniques, so that at least in those cases where the patient complains or would complain (if he or she could) about a bad impact caused by his social environment, psycho-techniques should be used to reverse the bad impact. But I gave it up to explain that kind of treatment to doctors of medicine (they just become incommunicative and do not move so much). --Riddick 10:33, 1 Oct 2004 (UTC)
• As far as I understood Scientology they claim to have found a purely psychological approach. --Riddick 10:33, 1 Oct 2004 (UTC)

• For a balanced view of Scientology you should read the controversy pages as well. Scientology has run into many problems in many countries. --CloudSurfer 17:31, 1 Oct 2004 (UTC)

Involuntary ECT

In case of catatonia it should be possible to "force feed" (e. g. by those slimy fatty fluids, glucosis and isotonic (NaCl) water infusions (my father had them after his belly did not heal after some surgery)). Does anybody know, why refusing to eat is considered to be an exculpation for ECT? --Riddick 10:14, 30 Sep 2004 (UTC)

In catatonia and in severe depression a refusal or inability to take fluids and food requires a relative level of intensive care for a psychiatric hospital. Intravenous treatment is very difficult in a ward of disturbed people. Anyone receiving intravenous, or nasogastric treatment is liable to have their tubes interfered with unless they are treated specially in an individual room. This is usually possible but does require the facilities and the staff resources. The problem then becomes how to treat the person. Experience has shown that ECT works better than medication in these severe and very uncommon problems. That is why it is used. Your use of the word "exculpation" suggests that you believe that ECT is essentially harmful and that its use could evoke blame. All treatments have risks and complications. ECT, in the consensus opinions which are provided in the links, at times presents an equal risk and at other times presents a lower risk than other treatments. No treatment is perfect but doctors try to pick the least harmful and most effective treatment for a specific condition. A core element of the Hippocratic oath is, "In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing ..." and this part of the the oath has been paraphrased into the Latin phrase "Primum non nocere" (first do no harm) which, despite not being in the oath is still an oft repeated phrase that governs the ethics and actions of doctors worldwide. Over the centuries these treatments change and I have no doubt that one day better treatments than ECT will emerge. At present however, ECT remains the most effective treatment for catatonia and severe depression and that is why it continues to be used seventy years after its invention despite the availability of a raft of antidepressants. By comparison, psychosurgery has all but disappeared to be replaced by effective antipsychotics. --CloudSurfer 01:27, 1 Oct 2004 (UTC)

• Since 1991 I wonder why patients, who refuse to move, are not moved into a intensive care unit. But the leading M.D just allowed a short-term transfer for implementing a central veneous access point (afterwards he was quite satisfied with the work of his colleagues; he just complained about missing stitches where the hose entered the body). But I gave it up to ask (them)... --Riddick 10:14, 1 Oct 2004 (UTC)

• Catatonia is a very uncommon condition. In my years of working in the field I have seen it once, but then I haven't spent a lot of time working in the psychiatric hospitals where people with this disorder are admitted. Because the patient is largely unresponsive it is usually impossible to obtain informed consent for any procedure. Added to that is the great difficulty in treating this condition. ECT is believed to have a role in catatonia but I wonder if a trial has been done comparing ECT with clozapine (the most effective antipsychotic medication). The problem in doing trials with rare conditions is recruiting enough subjects to obtain statiscally valid results. Such a study would probably have to be multi-centre and even then may take several years to collect the numbers. To make it double blind all the patients would then have to be given tablets and referred off to ECT. Those in the tablet trial would get the active drug and dummy ECT and those in the ECT trial would get a placebo and real ECT. The treating doctors would then rate their progress and switch non responders after a set time to the alternate group. Perhaps this study has been done but I am not aware of it. --CloudSurfer 17:51, 1 Oct 2004 (UTC)

• By the way: In F.Rep.Germ the Hippocratic oath was substituted by another oath (e. g.: in order to reflect the new pregnancy abortion law), that still says something like "The M.D shall care for the health of the patient first". But there is hear-say about M.D.s who believe that psychiatric treatment should create a "rehabilitation pressure" on the patient, and that this pressure results in a certain suicide rate, that should not be below a certain rate, which sounds quite cruel and like a third justice system (i. e.: 1. criminal, 2. civil, 3. medical) to me... --Riddick 10:14, 1 Oct 2004 (UTC)

[N.B.: This is, however, factually wrong. Doctors in Germany are not sworn in under an oath. There is a thing called the "Approbationsordnung für Ärzte" based on another set of laws the "Bundesärzteordnung", which is by no means an oath (would be a pretty long one to recite as well at that ;-)) but rather something like a legal act. And of course we would all be grateful to see a link to a published case or an independent source giving us a more in-depth run-down of an alledged principle in German psychiatry that systematically drives its patients into suicide. This smacks of conspiracy theory IMHO and sure is a great help in an effort to stop stigmata and misconceptions about mental health from propagating. --Ft. Jack Hackett 20:37, 19 November 2005 (UTC)]

• Yes, the Hippocratic oath is an old one and has been changed over the years. The concept of doing no harm remains critical and believed by the vast majority of doctors as being a guiding principle. Psychiatric treatment can put pressure on people but psychiatrists and others working in the field try to prevent that leading to bad consequences. Without some pressure, either internal or external, change will not occur. --CloudSurfer 17:51, 1 Oct 2004 (UTC)

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CloudSurfer, you are woefully misinformed. Electroshock is gaining in popularity throughout North America and so is psychosurgery. Lobotomies are being done again at the Vancouver General Hospital. The case that I know of involved a patient who suffered from debilitating obsessive-compulsive disorder. After his lobotomy, he had a whole new set of problems to contend with PLUS the original obsessive-compulsive disorder.

Electroshock does "work" in the short-term if by "work" you mean "has an effect." So does smoking crack but that's hardly justification to force people to smoke crack. The effects are indeed short-term: the brain takes about four weeks to recover from a closed head injury. With that recovery, the initial euphoria from electroshock is lost. It is for this reason that many psychiatrists recommend "maintenance ECT" which is usually once a month and continues indefinitely.

Psychiatry, and all of medicine, is great at ignoring the people who are affected the most. There are very good books written by electroshock survivors and you might want to check them out. Wendy Funk writes of her devastating brain damage post-electroshock. She had to teach herself to read and write again. She had to be reintroduced to her children.

I, myself, am almost 12 months after electroshock and I still have trouble finding my way around my home town (I have lived here since 1974). If anybody wants to find out the truth about electroshock, they need only to speak to an electroshock survivor.

The Coalition Against Psychiatric Assault is calling for a complete ban on electroshock (whether by consent or otherwise) and I support them 100% in this goal. There was also recently a very large civil judgment awarded in the USA to an electroshock survivor.

I am appalled at your wilful ignorance of human rights violations in psychiatry. The so-called "mentally ill" are the last sector of our society to be awaiting our human rights. -- EFS

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CloudSurfer writes: "Experience has shown that ECT works better than medication in these severe and very uncommon problems. That is why it is used. Your use of the word "exculpation" suggests that you believe that ECT is essentially harmful and that its use could evoke blame."

Contrary to your statement here, CloudSurfer, electrock is quite common and is not saved for "severe and very uncommon problems." It is not a treatment of last resort; rather, it is one weapon in an arsenal which includes talking therapy and drug therapy. The preponderance of evidence confirms that electoshock is indeed harmful and, beyond that, common sense would tell you that electroshock would have to be harmful. To suggest otherwise is to deny the obvious. The use of electroshock does indeed evoke blame and we will see more lawsuits in this regard, including MINE. -- EFS

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CloudSurfer also writes: "By comparison, psychosurgery has all but disappeared to be replaced by effective antipsychotics."

Please see my comment re psychsurgery above. Furthermore, there is no such thing as an "antipsychotic." What these drugs, including the newer "atypical antipsychotics," are is actually major tranquillizers. They depress the central nervous system and thus lessen psychosis, as well as the ability to think clearly and many other critical functions. So-called antipsychotics were used by the Soviets to torture dissidents. Patients on excessive levels of them are literally subhuman: they stare, they drool, they are utterly unable to function. These drugs are often used in psychiatric wards for patient "management" because patients drugged to their eyeballs are much easier to handle.

Antipsychotics are implicated in tardive dyskinesia, a devastating and permanent condition (also referred to as Parkinsonian syndrome, because the symptoms are similar) that often drives patients to suicide from the stigma of this affliction alone. The scientific evidence on TD rates vary: it is AT LEAST 10% but could be high as 40%. The newer antipsychotics, the so called atypicals, MAY be safer in this regard but they have not been in use long enough to safely make that determination. The word tardive refers to the fact that this condition may come on at any time (weeks, months, years, decades) after the use of antipsychotics. -- EFS

Antipsychiatry view

I have edited a recent entry by User:Riddick and I hope I have rendered his meaning. With the paragraph below I am afraid I just don't understand what he is trying to say. I have removed it to the talk pages so that it might be rendered into clear English before being reinserted into the controversy section.

According to Antipsychiatry ECT is used to suppress certain individual, non-criminal, a little bit uncommon properties of the patients (examples for such cases: Retraumatizing the Victim, Case Reports: Restraint Deaths & Abuse).

--CloudSurfer 23:57, 11 Oct 2004 (UTC)

Thank you for your effort on correcting my texts.

• I have a little problem with your rendered text: The trailing "according to CCHR" looks a little bit funny to me due to the "which" after the comma. Maybe we should point out, that the Scientology Church established CCHR in order to fight human rights crimes?
• My English is possibly too bad... I do not even see, what is wrong with my text about Antipsychiatry. I wanted to express,

1. that there is an organization, that is called Antipsychiatry
2. that they believe, that there is no real psychiatric illness in most cases (e. g. Mr. Alan Turing) or [1])
3. that they believe, that psychiatrists mostly (at least in 1950) want/wanted to suppress behaviour, that freightens them or that is uncommon
4. and that they believe, that psychiatrists often treat behaviour, that can be seen as completely healthy and legally allowed.

I would be glad, if you could produce a comprehensible sentence.

Do not hesitate, please, to ask me further questions. :-))

--Riddick 01:08, 12 Oct 2004 (UTC)

How do these look now?

The Church of Scientology's Dianetics claims that ECT does not treat the cause of the disorder but suppresses natural reactions to certain influences by creating further disorders. The CCHR, an institution set up by Scientology, also claims that the real nature of psychiatry is that of human rights abuse.

Antipsychiatry believes that, for the most part, there are no real mental illnesses and that ECT is used to suppress certain behaviors which, although perhaps uncommon, are still within the normal range. (See: Retraumatizing the victim and Case reports: restraint deaths & abuse for examples of such cases.)

I have reworded the first paragraph which is still in the text as the original. The second paragraph is a rewording based on what you have written above. If you put them in yourself don't forget to take out the colons at the beginning of each paragraph. --CloudSurfer 02:04, 12 Oct 2004 (UTC)

I like both paragraphs and I copied them to the article (and I remembered to remove the colons)... Thank you. --Riddick 02:49, 12 Oct 2004 (UTC)

I remembered, that the "consent" might be questionable under the influence of psychotropic substances (again according to CCHR). E. g. there was a case in F.Rep.Germ where a patient in the beginning did not like a certain treatment (castration) and after some months of treatment by psychiatrists he agreed. Do you think we should mention that? If yes: I would be glad, if you could find an apropriate wording. --Riddick 02:49, 12 Oct 2004 (UTC)

We are talking about ECT not castration (thank heavens). I actually think that is better going into the article about informed consent, which I haven't really looked at. See what you think. There could then be a reference such as:

Some question the effects of drugs on the ability to give informed consent.

But I do think this should be further explained in the informed consent article, preferably with a reference. --CloudSurfer 03:19, 12 Oct 2004 (UTC)

I would only like to say that the use of ECT in cases of severe cases can be useful and not just for behavioral control but behavioral support if the patient is agreeable to the process. I have a patient who has experienced severe situations that is neither normal nor healthy by anyones standards and this patient is undregoing ECT with the hopes that it will help so no matter who argues to the contrary I am in hopes that this is a success. (Coco1)

---

It's important that you understand that scientologists are but one subset of the anti-electroshock movement. It's a common slur of mainstream psychiatry to call any anti-electroshock activists scientologists. The only reason scientologists are linked in the public's mind to this issue is because their church has a lot of money and publicly speaks out. But please keep in mind that anti-electroshock does NOT equal scientologist. -- EFS

Clarification required on the separation of treatment.

The last sentence in the second last paragraph in the overview reads:

Studies have shown that each fit must be separated by a day at least.

...or what? Is the treatment ineffective? Does it result in some sort of damage? Does the sky fall? What happens if fits are not separated by at least a day? The reader is left expecting more, but unfortunately the sentence unexpectedly ends.

--PJF ^(talk) 08:31, 19 Feb 2005 (UTC)

Cites needed

I removed this sentence from the article:

Even though ECT is "safe", passing the current through the 'non-dominant' hemisphere is "safer" — unless of course, one happens to be an artist, musician, or other professional who depends upon the right hemisphere for creativity.

This appears to be highly POV, unless evidence can be supplied to back it up. Cites, please? -- The Anome 08:45, May 20, 2005 (UTC)

---

WHO DELETED MY LINK TO AN EXCELLENT REFERENCE,DR. PETER BREGGIN'S PAPER ON ELECTROSHOCK? AND WHY? -- EFS

EFS, I don't think shouting will get you anywhere and the rationale has been explained (withdrawn, see above Ft. Jack Hackett 14:43, 19 November 2005 (UTC)).. --81.179.80.131 15:40, 17 November 2005 (UTC)

I don't recall seeing any explanation of why Dr. Peter Breggin's article on electroshock was deleted. Could you give the explanation again, please? Francesca Allan of MindFreedomBC 01:57, 19 November 2005 (UTC)

Sorry, it has in fact not been explained, you're absolutely right, see my notes above though. However I think in the controversy section quoting of his site is quite adequate. Also, this wikipedia article seems fairly balanced and very informative to me as it stands, minus perhaps the "...because of its brain damaging effects.". There would really have to be scientific evidence for such physical brain damage claims to be included here. Although, mentioning that there are groups that perceive ECT as brain damaging is quite in order IMHO. Ft. Jack Hackett 14:43, 19 November 2005 (UTC)

So what you're saying is that the Breggin article can't stay because you don't like it. The Breggin article specifically deals with the brain damaging effects of electroshock so what's the problem? Francesca Allan of MindFreedomBC 03:39, 2 December 2005 (UTC)

Who are you to decide whether or not a reference can stay in? It's a great article. It's very informative and raises troubling questions about electroshock and this wikipedia article is about electroshock. Please clarify your position or back down. Francesca Allan of MindFreedomBC 03:43, 2 December 2005 (UTC)

Requiem for a dream

HI!

I just thought, that Requiem for a dream does not need to be mentioned, since ETC is not so apparent there (only administered at the very end, and the long-term effects are not visible). When cleaning up the article, I think this example can be taken out. "One flew over the cuckoo's nest" and "The bell jar" are the most prominent examples, and they well deserve to be noted. Just an idea - didn't want to edit the article, in case you people object. Please write "oppose" or "in favor" below. --Msoos 10:40, 12 October 2005 (UTC)

• In favor --Msoos 10:40, 12 October 2005 (UTC)

A wild paragraph

I removed the following, not necessarily because it is wrong but because it is speculative enough to warrant scrupulous sourcing:

Relationship of ECT to Religious Practices for Inducing Ecstatic Seizures

The efficacy of ECT for treatment of severe depression have led some to speculate that the seizures observed in some forms of ecstatic religious practice, e.g. among the Holy Ghost, Slain in the Spirit, Shakers, Pentecostals, Shamanic, and Kundalini Yoga practitioners, are serving a similar function in relieving symptoms of depression. Those who support this view theorize that the evolution of such seizure-inducing practices, which is widespread among the world's religions, may have been selected for by an accidental process but remain as cultural traditions due to the emotional benefit the practitioners feel they receive. Some feel that candidates for ECT might benefit from participating in such religious practices if they have a prior religious predisposition.

While it sounds interesting and probably factual, it is unsourced and fairly speculative. Comments? JFW | T@lk 10:24, 21 October 2005 (UTC)

Sources

A lot of the sources quoted in the text are not actually properly referenced. Only the Blumenfeld ref is there (in the external links section), and the Abrams reference does not even have an antecedent in the text. I could do with some help in fixing this. Any ideas on whether we should be using footnotes for this? JFW | T@lk 10:37, 21 October 2005 (UTC)

Question

Who added this sentence: "Some recent studies suggest the opposite; long term ECT treatment, like antidepressant treatment, seems to protect the brain from the damaging effects of depression." and why? What studies? Why the hell is this in here? I'm taking it out until it's properly sourced. Francesca Allan of MindFreedomBC 05:25, 15 November 2005 (UTC)

Sorry, I now see that you are referring to that study which you mention right afterwards. Still, one 1998 study doesn't translate to "some recent studies" very well. I'm going to find Peter Breggin's article and link it here. Last time I did so, a wiki-vandal took it out. Francesca Allan of MindFreedomBC 05:30, 15 November 2005 (UTC)

Hi, there are a few papers on neuroprotective action of ECT/ECS: cf. Nibuya M, Morinobu S, Duman RS. Regulation of BDNF and trkB mRNA in rat brain by chronic electroconvulsive seizure and antidepressant drug treatments. J Neurosci. 1995;15:7539-7547. Also http://www.cnsspectrums.com/pdf/art_360.pdf (this actually cites the above article). --81.179.80.131 15:34, 17 November 2005 (UTC)

As Peter Breggin points out in the article which is not allowed to be linked to this page, rat research has a very tenuous relationship with human research. The overwhelming majority of electroshock survivors report serious short-term memory disturbance and many of them report long-term difficulties. This isn't indicative of "neuroprotective action." In summary, I don't give a rat's ass. Francesca Allan of MindFreedomBC 02:00, 19 November 2005 (UTC)

Can you point me towards a controlled study that shows that "many" ppl objectively experience long-term memory loss? --81.179.80.131 10:13, 19 November 2005 (UTC)

Excuse me. Why do we need a controlled study to confirm that many electroshock survivors are harmed? Why is psychiatry not held to the same standard? Electroshock survivors (including myself) report devastating memory problems. For about one year afterwards, I read the same book over and over because I simply could not retain what I read. Why this wilful blindness to first-hand knowledge of electroshock? Have you been electroshocked? If not, perhaps you should drop the attitude. Francesca Allan of MindFreedomBC 16:12, 1 December 2005 (UTC)

Oh, and BTW, "serious" memory loss for the day of/the hours around the time of treatment, yes. This is probably a combined effect of both the current and the anaestethic procedure. Unless, again, you have first hand experience or a study that proves otherwise. --81.179.80.131 10:17, 19 November 2005 (UTC)

Memory loss is much more involved than just around the treatment. The effects seem to last months, years, even decades. Sadly, I do have first hand experience. Francesca Allan of MindFreedomBC 16:12, 1 December 2005 (UTC)

I am sorry that your experience did not work out well for you but it really is not terribly relevant. The fact remains that research has shown that for the vast majority of people the memory loss is not experienced as you describe it. djheart 06:24, 2 December 2005 (UTC)

If it were just me, of course, it wouldn't be terribly relevant. However, I'm not alone. Many people are hurt in the long term by electroshock. Even though this may not be true for the "vast majority," it is still relevant. Psychiatric "research" has a way of excluding the experiences that count the most: that of the patients. Francesca Allan of MindFreedomBC 14:46, 2 December 2005 (UTC)

And another thing: I think the expression "...because of its brain damaging effects." is in serious need of being rephrased, as it implies that it is a given notion, backed by scientific research, which it certainly isn't. I would therefore suggest that we change it to: "...and claim it has brain damaging effects." or "...because they perceive it as brain damaging.". So unless I find a controlled study/bio-/neurochemical research paper cited here that shows the equivalent of the scientific community perceiving ECT as clearly brain damaging I will reenforce introduce this change myself in a week's time. --Ft. Jack Hackett 12:14, 19 November 2005 (UTC)

No, you were right the first time. You're a wiki-bully and you want to force your POV even if it destroys the article. Francesca Allan of MindFreedomBC 04:19, 2 December 2005 (UTC)

Your faith in "controlled" neurobiological research is quaint. Let's not forget the horrors that peer-reviewed studies have brought us in the past. Francesca Allan of MindFreedomBC 16:12, 1 December 2005 (UTC)

The scientific community is notorious for being blind to the obvious. The fact that psychiatrists don't care enough about their patients to investigate these claims is a reflection on the arrogance of psychiatry, and has nothing whatsoever to do with the validity of the patients' claims. Electroshock is brutal and should be abolished. Francesca Allan of MindFreedomBC 04:14, 2 December 2005 (UTC)

I revised risks section so that it no longer reads that ECT causes brain damage. Wikipedia has an anti-pseudoscience policy and as I already discussed at length on the psychiatry talk page there is no credible scientific evidence that ECT causes brain damage (and please don't use a Breggin quote again as defense, it's getting tiring). I will delete any references to brain damage that don't qualify the statement by stating that the idea of brain damage is only supported by one a small minority of researchers (which I think is a generous thing to say since so far you have only fished out one guy). djheart 06:17, 2 December 2005 (UTC)

"Pseudoscience"? The whole of psychiatry is pseudoscience, at best. And why aren't we allowed to use Breggin as a source? Because you find it "tiring." I see. You're pretty tiresome youself, djheart. Francesca Allan of MindFreedomBC 14:49, 2 December 2005 (UTC)

I never said you can't use Breggin as I source, I'm just saying that it seems to be your only source (well Breggin and your own personal experience) and the only crutch you are standing on to support your ideas. On a side-note I won't continue this discussion if you continue with ad homenum (sp?) attacks. djheart 01:42, 5 December 2005 (UTC)

Not just my own personal experience, djheart. Unlike yourself, I am keenly interested in what other psychiatric survivors have to say and take their complaints of memory damage and ongoing confusion very seriously. It's hard to say whether long-term memory problems constitute brain damage but it's certainly worth exploring. See Wendy Funk's book "What Difference Does It Make?" Read about Leonard Frank's experiences. If you want to engage in a civil discussion, then perhaps you should drop your sneering attitude. I don't need a "crutch" to support my "idea" that electroshock is harmful. Perhaps you need a crutch to support your idea that you're in a helping profession. I believe that all of psychiatry labours under a similar delusion. Francesca Allan of MindFreedomBC 05:56, 5 December 2005 (UTC)

Patients' views

withdrawn. etc.org does not allow posting of this here... sorry Ft. Jack Hackett 16:11, 22 November 2005 (UTC)

CITE

There is a big problem here. It's called WP:CITE. The article contains numerous Harvard-style pointers at references but.... there are no references at the end of the article. This is serious. We can't expect every reader to go to the PubMed site and dig for hours to find the correct material. I've added the original Cerletti paper (1938) as a starter, but someone really needs to find the Surgeon General's original article and copy whatever references are mentioned into this article. JFW | T@lk 19:40, 5 December 2005 (UTC)

JDWolff, please.

The problem of psychiatry lacking "informed consent" is self-evident from mental health legislation. Patients are offered the choice of treatment. If they refuse, they're deemed incompetent and consent is dispensed with. In British Columbia, this is called "deemed consent" and what it means in plain English is "no consent." Similar problems exist across Canada and I'm quite sure it's true in many states of the USA. Could you please explain why you tolerate such a double wiki-standard? Anything remotely anti-psychiatry has to be backed up (and even then pro-psychiatrists complain about the validity of the references) but psychiatrists are allowed to blather on about any highly improbable information they care to without fear of contradiction. I was under the impression that we were getting along quite nicely, JDW, so please don't let me down. Please endeavour to hold both sides to the same standard. Anything less is highly POV. Francesca Allan of MindFreedomBC 02:00, 6 December 2005 (UTC)

As for the UBC research, Dr. Christina Kaloff presented this within the last few weeks. I don't know if it's available on the internet yet. Francesca Allan of MindFreedomBC 02:03, 6 December 2005 (UTC)

I'm not letting you down. I'm just mindful of our verifiability policy. The statements on bypassing consent can be reintroduced without rewording if it gets a source. Possibly you could contact Dr Kaloff's secretary and request where it will be published. JFW | T@lk 02:33, 6 December 2005 (UTC)

I'll see what I can get from UBC. As for the other matter (bypassing consent), what about citing the relevant legislation? It's clear enough that consent is not required. Francesca Allan of MindFreedomBC 04:06, 6 December 2005 (UTC)

You may actually have better sources than me on this subject. I'm speaking from experience in The Netherlands, where legislation is very much against forced treatment. Are you aware of any comparative studies between the laws of various jurisdictions in regard to involuntary treatment? JFW | T@lk 05:16, 6 December 2005 (UTC)

I seem to remember reading something about this some time ago. I'll see if I can find it again. As for your country being against forced treatment ... Hooray, Netherlands! Francesca Allan of MindFreedomBC 15:01, 6 December 2005 (UTC)

Francesca, in Ontario and Quebec ECT can only be given if either the patient or a substitute decision maker consents to it since it is not an emergency procedure. I'm not sure about the legislation in BC but I'd be quite surprised that it would be much different from the legislation here where the only situation where treatment can be given without such consent (again from patient or SDM) is in emergency situations (e.g. sedation of a patient suffering from psychosis who is acting violently) djheart 05:43, 6 December 2005 (UTC)

Well, I am familiar with the legislation in BC and it's quite different than what you describe above. Consent (either by the patient or a substitute decision maker) is not required. BC's Representation Agreement Act (which allows for people to nominate their substitute decision maker) specifically excludes any medical decisions which would fall under the Mental Health Act. Francesca Allan of MindFreedomBC 14:58, 6 December 2005 (UTC)

Another problem is psychiatrists ignoring mental health legislation secure in the knowledge that the average mental patient has very limited avenues of redress. That happens in BC a lot. Francesca Allan of MindFreedomBC 15:01, 6 December 2005 (UTC)

But should Wikipedia turn into a battlefield because of the situation in BC? Honestly, I'm warmly in favour of representing the issue of forced treatment accurately, but not if this leads to problems of balance. I'm unfamiliar with the legal status in the US and Canada, but the Netherlands have fairly strict rules for prolonged involuntary confinement in closed units and involuntary treatment. In the UK, the basic requirements for involuntary treatment appear to be less strict, although I have not worked in psychiatry here. JFW | T@lk 15:42, 6 December 2005 (UTC)

No, of course not but BC is not particularly unusual. You seem to have backed off your position on the Netherlands a little bit. Above you said legislation was very much against forced treatment but here you are saying there are fairly strict rules for prolonged confinement and involuntary treatment. Francesca Allan of MindFreedomBC 07:34, 7 December 2005 (UTC)

I meant strict from the point-of-view of the psychiatrists, i.e. the patient had to satisfy specific criteria and a judge came to the unit to meet with the doctors and the patient. JFW | T@lk 22:50, 7 December 2005 (UTC)

Rsabbatini

You made the following edit summary: "Controversy - removed spamlink, CCHR is a front for the Church of Scientology, so it is not NPOV."

I'm curious. Although I am no fan of the Church of Scientology, I'm wondering about your logic here. Why is CCHR POV? NAMI, by way of comparision, is a front for Big Pharma but I'm sure you'll happily allow references to NAMI. Just wondering about the double standard. Please explain, if you can. Francesca Allan of MindFreedomBC 04:04, 13 December 2005 (UTC)

Comment

What kind of torture is this? I know a woman who is having this procedure. She has no idea why she agreed to this, no idea if it is effevtive {she dosn't think so}, no idea how long she will be subjected to this crime. Her doctors give her very little info as they believe she won't understand. When we first met 2 years ago she was bright, bubbly, and vivacious. Now she's broccoli. This is a sick procedure and so are the people who perform it. "Faces Off" — Preceding unsigned comment added by 65.147.117.234 (talk • contribs)

One presumes from your comments that you feel the proceedure is unwarrented, but has the person concerned not got a mental illness ? Might not the mental health illness in itself be the cause of the changes you observe ? If ECT is being used, were other treatments tried first (most psychiatrists would prefer the simpler task of writing out a presdription for a drug and letting the patient self-administer their treatment), if so were they not effective ? For the patient to have "no idea why she agreed to this" she needs disagree that she has a mental illness, no idea if drugs previously used, no idea if she felt better on any previous drugs given. I suspect ECT was not given to a person who was completely well for no reason... David Ruben ^Talk 00:09, 21 January 2006 (UTC)

Citations

Please provide full citations, especially when making controversial assertions. --John^DO|^{Speak your mind} I doubt it 22:18, 20 January 2006 (UTC)

Despite 2 reversions asking for full citations, an anonymous editor(s) has repeatedly inserted strongly POV assertions providing incomplete (name, date) citations. The insertion of this material should include full citations especially given its controversial nature. This has been stated repeatedly in edit summaries and here to no avail. The anonymous editor persists. --John^DO|^{Speak your mind} I doubt it 23:00, 20 January 2006 (UTC)

Interesting, I will start reviewing the citations. Thank you for providing them. --John^DO|^{Speak your mind} I doubt it 08:27, 21 January 2006 (UTC)

Information Re: Based Edits to this page

Hiya, this is Thor from the Counter Vandalism Unit of Wikipedia. I have reverted yet ANOTHER anonymous edit by an IP user on the section of this page where NPOV is disputed. The report made is now being listed with my superiors and I will make sure than any anonymous edits to this page which breach NPOV standards, will be reverted without further recourse to the editor. Please make sure your edits to this page conform to NPOV. Thanks Thor Malmjursson 00:44, 21 January 2006 (UTC) Wikipedia CVU - Talk to Thor

The annon user has reverted yet again - I now count x6 reverts within the last 24hrs. Several (revert) edit comments have asked that they discuss in the talk page prior further re-insertion of what is stated to be POV. This talk page already has past discussion about ECT & side-effects, so this is unilat action by the annon user. The annon user is re-editing at a faster rate and with a huge number of references (at least these are now being stated) that I suspect no practicing doctor has the time to wade through. The original version gave considered opinions that there is no credible evidence of harm (National Institue for Health), so the quoting of large numbers of anecdotal reports is hardly fair (pretty much every patient forcibly committed to a psychiatric ward and assessed as needing forced treatment by tablet or injection also claims unfair & unecessary treatment and that they are unwell as a result of the medication which they would like stopped). David Ruben ^Talk 02:59, 21 January 2006 (UTC)

Interesting, the anon user might be making POV-looking edits, but they seem to be referenced, which is rather interesting and unique. I'll see if I can leave a message to the anonymous user, and get them to discuss. Kim Bruning 03:55, 21 January 2006 (UTC)

---

To annon user User:209.122.225.245, you stated in your message to User:Tmalmjursson that you are new to wikipedia, so welcome ! We try to assume good faith by all editors and hope we don't bite the newcomers. So appologies if you failled to understand the revertion by several people of your edits and why your x6 reverts yesterday then caused you to be blocked under the Three revert rule. You clearly have detailled knowledge of this subject & the background medical literature and thus hopefully can contribute some well informed edits to this article.

• I have tried to place some thoughts on my understanding of wikipedia's attitudes and policies on your talk page. I hope you take these in a welcoming positive manner, to help you understand the reasoning behind the editors you encountered yesterday.
• Wikipedia is about writing a general encyclopedia, so there are restrictions on article length & number of references. Also NPOV is not about absolute truth, but fairly describing the majority & significant minority views. Your previous edits were seen as POV by others (whether or not you agree with them) especially as you also deleted out paragraphs written from a the majority view you disagree with.
• You are welcome to disagree with anyone but where agreement can not be found about different POVs, then discussion within an article's talk page should be held to try and reach a consensus on further edits. Your ignorance as a newcomer of how to determine this page's past history & discussion meant of course that you were unaware that your edits prompted a request to engage in discussion for a consensus and hence the reverts applied to your edits. We got increasingly irritated at your failure to engage as I suspect you obviously got increasing irritated at revertions you failled to understand...
• So please do not be upset if you find a majority disagree with you however 'valid' your feel your own assessment is :-)
• The major medical consensus is that ECT is acceptable. Of course even within the majority view there is debate as to the appropriateness of past or current selection of patients, mental conditions, methodology and of course consent. Even if one disagrees with any of these aspects, the majority medical & legal POV is still (rightly or wrongly) one that is positive towards ECT.
• You will see above in this talk page that there has been considerble previous discussion about the ECT article. Now, as a newcomer, I appreciate you will not have been aware how to view the Page History or this talk page and so continued to edit in ignorance of various editors' attempts to engage in discussion.

We all undergo a learning curve on joining wikipedia and hopefully don't get involved in disputes, content disputes, edit-wars etc - or at least not too often :-) So please discuss why the current discussion on side-effects of ECT is insufficient and the type of edits you wish to use. I'm sure that many will disagree with your views, but as I indicate on your talk page, WP is not about other editors imposing their idea of "truth" upon you, but rather reaching a consensus on the POVs that go to make up an article's overall NPOV in a general enclyclopedia (with some constraints on article size too) David Ruben ^Talk 02:18, 22 January 2006 (UTC)

Citations

In an effort to vet these citations, I will reproduce them here and review them with commentary. Perhaps we can all pitch in and vet them together. If I weren't on vacation, this would be insane. --John^DO|^{Speak your mind} I doubt it 06:12, 22 January 2006 (UTC)

• Cerletti U, Bini L. L'Elettroshock. Arch gen neurol psichiat psicoanal 1938;19:266-268.

No way to verify content online. Pubmed only goes to 1950 or so. But Cerletti was a pro ECT pioneer.--John^DO|^{Speak your mind} I doubt it 05:49, 22 January 2006 (UTC)

• Philpot M, Collins C, Trivedi P, Treloar A, Gallacher S, Rose D (2004). Eliciting users’ views of ECT in two mental health trusts with a user-designed questionnaire. Journal of Mental Health 13(4): 403-413.

This is from a journal which is not on pubmed, [2], I don't know how legitimate these folks are. --John^DO|^{Speak your mind} I doubt it 05:49, 22 January 2006 (UTC)

• Rose D, Wykes T, Bindman J, Fleischmann P (2005). Information, consent and perceived coercion: patients’ perspectives on electroconvulsive therapy. British Journal of Psychiatry 186: 54-59.

Legitimate cited journal, article states up to 1/3 of patients feel informed consent was not achieved. [3]--John^DO|^{Speak your mind} I doubt it 05:49, 22 January 2006 (UTC)

• Food and Drug Administration (USA), Dockets Management Branch, Rockville, Maryland. Docket #82P-0316: Electroconvulsive Therapy Device; Vols. 1-38, 1982---present.

The most available data online is here, doesn't say much except some rule was proposed and withdrawn. A worthless source. --John^DO|^{Speak your mind} I doubt it 05:49, 22 January 2006 (UTC)

• Cameron DG. ECT: sham statistics, the myth of convulsive therapy, and the case for consumer misinformation. J of Mind and Behavior 1994; 15(1-2): 177-198.

Another one not on pubmed, published by the university of maine [4]. This seems to be a speculative journal with fairly low standards and no mention of peer review. The article itself is from an anti-ect group. --John^DO|^{Speak your mind} I doubt it 05:49, 22 January 2006 (UTC)

• Calev A. Neuropsychology and ECT: past and future research trends. Psychopharmacology Bulletin 1994; 30(3): 461-464.

A journal on pubmed. [5] --John^DO|^{Speak your mind} I doubt it 05:49, 22 January 2006 (UTC)

• Freeman CP, Weeks D, Kendell RE. ECT II: Patients who complain. Br J Psychiatry 1980; 137:8-16.

A pubmed journal indicating cognitive deficits in some ect patients. [6] --John^DO|^{Speak your mind} I doubt it 05:49, 22 January 2006 (UTC)

• Peddler M. Shock Treatment: A Survey of People's Experience of Electroconvulsive Therapy (ECT). London: MIND, 2000.

Apparently a book. Can't find it except as a citation in some other papers. --John^DO|^{Speak your mind} I doubt it 05:49, 22 January 2006 (UTC)

• SURE (Service User Research Enterprise). Review of Consumers' Perspectives on Electroconvulsive Therapy. London: Department of Health, January 2002.

Article is here--John^DO|^{Speak your mind} I doubt it 05:49, 22 January 2006 (UTC)

• Janis IL. Psychologic effects of electric convulsive treatments (I. Post-Treatment Amnesias). Journal of Nervous and Mental Disease 1950(a); 111: 359-381.

Journal is on pubmed. The article is not in their archive which goes back to 1950[7]--John^DO|^{Speak your mind} I doubt it 06:12, 22 January 2006 (UTC)

• Videotape deposition of Harold Sackeim. PhD, Case No. 01069713, Atze Akkerman and Elizabeth Akkerman v. Joseph Johnson, Santa Barbara Cottage Hospital, and Does 1-20, Court of the State of California for the County of Santa Barbara, Anacapa Division, March 14, 2004

You gotta be kidding. --John^DO|^{Speak your mind} I doubt it 06:12, 22 January 2006 (UTC)

• Cott, Jonathan. On the Sea of Memory. New York: Random House, 2004.

A book by an ect patient relating to memory loss. --John^DO|^{Speak your mind} I doubt it 06:12, 22 January 2006 (UTC)

• Templer DI, Veleber DM. Can ECT permanently harm the brain? Clinical Neuropsychology 1982; 4(2): 62-66

I can't find this article except on anti-ect websites like this. The article does not exist on pubmed. --John^DO|^{Speak your mind} I doubt it 06:12, 22 January 2006 (UTC)

• Colon EJ, Notermans SLH. A long-term study of the effects of electro-convulsions on the structure of the cerebral cortex. Acta Neuropathologica (Berlin)1975; 32: 21-25

A real article here, does not seem to be about humans. --John^DO|^{Speak your mind} I doubt it 06:12, 22 January 2006 (UTC)

• Weinberger DR, Torrey EF, Neophytides AN et al. Lateral cerebral ventricular enlargement in chronic schizophrenia. Archives of General Psychiatry 1979; 36: 735-739.

Real article concluding treatment did not affect ventricular enlargement. --John^DO|^{Speak your mind} I doubt it 06:12, 22 January 2006 (UTC)

• Calloway SP, Dolan RJ, Jacoby RJ, Levy R. ECT and cerebral atrophy. Acta Psychiatrica Scandinavica 1981; 64: 442-445

A real article. showing correlation between frontal lobe atrophy and ect. --John^DO|^{Speak your mind} I doubt it 06:12, 22 January 2006 (UTC)

• Templer RI, Ruff CF, Armstrong G. Cognitive functioning and degree of psychosis in schizophrenics given many electroconvulsive treatments. British Journal of Psychiatry 1973; 123: 441-443.

Real article not available even in abstract form. --John^DO|^{Speak your mind} I doubt it 06:37, 22 January 2006 (UTC)

• Shah PJ, Glabus MF, Goodwin GM, Embeier KP. Chronic, treatment-resistant depression and right fronto-striatal atrophy. British Journal of Psychiatry 2002; 180: 434-440.

Real article.Full text available. Conclusion was we cannot determine whether changes are the causes or consequences of treatment resistance, aggressive treatments such as electroconvulsive therapy or the illness process per se. --John^DO|^{Speak your mind} I doubt it 06:37, 22 January 2006 (UTC)

• Diehl DJ, Keshavan MS, Kanal E, et al Post-ECT increases in T2 relaxation times and their relationship to cognitive side effects: a pilot study. Psychiatry Res 1994 (November); 54(2): 177-184.

Real article about MRI findings, does not support the text inserted. --John^DO|^{Speak your mind} I doubt it 06:37, 22 January 2006 (UTC)

• Marcheselli et al. Sustained induction of prostaglandin endoperoxidase synthase-2 by seizures in hippocampus. J Biol Chem 1996; 271: 24794-24799.

Good article with almost no clinical relevance and not supportive of any of anon's additions. full text --John^DO|^{Speak your mind} I doubt it 06:37, 22 January 2006 (UTC)

• Andreasen et al. MRI of the brain in schizophrenia. Archives of General Psychiatry 1990; 47: 35-41.

Real article, abstract does not mention ECT at all. [8]--John^DO|^{Speak your mind} I doubt it 06:37, 22 January 2006 (UTC)

• Dolan et al. The cerebral appearance in depressed patients. Psychological Medicine 1986; 16: 775-779

Paper showing sulcal widening in ECT patients compared to non-treated patients. [9] --John^DO|^{Speak your mind} I doubt it 06:37, 22 January 2006 (UTC)

• Figiel G, Coffey E, et al. Brain MRI findings in ECT-induced delirium. Journal of Neuropsych and Clin Sci 1990: 2: 53-58

Interesting article, not about the subject of long term side-effects. [10] --John^DO|^{Speak your mind} I doubt it 06:37, 22 January 2006 (UTC)

• Ebaugh FG, Barnacle CH, Neubuerger KT. Fatalities following electric convulsive therapy. A report of two cases with autopsy findings. Transactions of the American Neurological Association 1942; 36.

Case reports --John^DO|^{Speak your mind} I doubt it 21:07, 22 January 2006 (UTC)

• Gralnick A. Fatalities associated with electric shock treatment of psychoses: report of two cases, with autopsy observations in one of them. Archives of Neurology and Psychiatry 1944; 51: 397.

Case reports in pre pubmed journal --John^DO|^{Speak your mind} I doubt it 21:07, 22 January 2006 (UTC)

• Jeter WW. Fatal circulatory failure caused by electric shock therapy. Archives of Neurology and Psychiatry 1944; 51: 557.

Same --John^DO|^{Speak your mind} I doubt it 21:07, 22 January 2006 (UTC)

• Meyer A, Teare D. Cerebral fat embolism after electric convulsive therapy. British Medical Journal 1945; 2: 42.

Same --John^DO|^{Speak your mind} I doubt it 21:07, 22 January 2006 (UTC)

• Sprague DW, Taylor RC. The complications of electric shock therapy with a case study. Ohio State Medical Journal 1948; 44: 51-54.

Same --John^DO|^{Speak your mind} I doubt it 21:07, 22 January 2006 (UTC)

• Will OA, Rehfeldt FC. A fatality in electroshock therapy: report of a case and review of certain previously discussed cases. Journal of Nervous and Mental Disease 1948; 107: 105-126.

Same --John^DO|^{Speak your mind} I doubt it 21:07, 22 January 2006 (UTC)

• Martin PA. Convulsive therapies: review of 511 cases at Pontiac State Hospital. Journal of Nervous and Mental Disease 1949; 109: 142-157.

Not accessible --John^DO|^{Speak your mind} I doubt it 21:07, 22 January 2006 (UTC)

• Riese W, Fultz GS. Electric shock treatment succeeded by complete flaccid paralysis, hallucinations, and sudden death.

incomplete citation --John^DO|^{Speak your mind} I doubt it 21:07, 22 January 2006 (UTC)

• Liban E, Halpen L, Rozanski J. Vascular changes in the brain in a fatality following electroshock. Journal of Neuropathology and Experimental Neurology 1951; 309-318.

Case report here --John^DO|^{Speak your mind} I doubt it 21:07, 22 January 2006 (UTC)

• Corsellis J, Meyer A. Histological changes in the brain after uncomplicated electro-convulsive treatment. Journal of Mental Science 1954; 100: 375-383.

Inaccessible [11] --John^DO|^{Speak your mind} I doubt it 21:07, 22 January 2006 (UTC)

• Madow L. Brain changes in electroshock therapy. American Journal of Psychiatry 1956; 113: 337-347.

Inaccessible [12] --John^DO|^{Speak your mind} I doubt it 21:07, 22 January 2006 (UTC)

• Faurbye A. Death under electroshock treatment. Acta Psychiatrica Neurologica 1942; 17: 39.

Inaccessible --John^DO|^{Speak your mind} I doubt it 21:07, 22 January 2006 (UTC)

• Maclay WS. Death due to treatment. Proceedings of the Society of Medicine 1953; 46: 13-20.

Inaccessible --John^DO|^{Speak your mind} I doubt it 21:07, 22 January 2006 (UTC)

• Matthew JR, Constan E. Complications following ECT over a three-year period in a state institution. American Journal of Psychiatry 1964; 120: 1119-1120.

Inaccessible [13]--John^DO|^{Speak your mind} I doubt it 21:07, 22 January 2006 (UTC)

• Barker J, Baker A. Deaths associated with electroplexy. Journal of Mental Science 1959; 105: 339-348.

PMID 13665295. No abstract/full-text available.

• Andre L (2001, May 18). Testimony at the public hearing of the New York State (U.S.) Assembly Standing Committee on Mental Health on electroconvulsive therapy.

I would consider this evidence to be too anecdotal. --Uthbrian (talk) 06:38, 22 January 2006 (UTC)

• Donahue A (1999, March 12). Testimony at the public hearing of the Vermont (U.S.) Health and Welfare Committee on electroconvulsive therapy.

I would consider this evidence to be too anecdotal. --Uthbrian (talk) 06:38, 22 January 2006 (UTC)

• Rose D, Fleischmann P, Wykes T, Leese M, Bindman J (2003, June 21). Patients' perspectives on electroconvulsive therapy: systematic review. British Medical Journal 2003 (June 21): 326 (7403,1363-1367, 2003

PMID 12816822. Free full-text available. Is not a randomized controlled trial, but may be worth looking over. --Uthbrian (talk) 06:38, 22 January 2006 (UTC)

• Squire LR, Slater PC (1983). Electroconvulsive therapy and complaints of memory dysfunction: a prospective three-year follow-up study. British Journal of Psychiatry 142: 1-8.

PMID 6831121. Discusses factors which may influence self-reporting of memory problems. --Uthbrian (talk) 06:38, 22 January 2006 (UTC)

• Heilbrunn G, Liebert E. Biopsies on the brain following artificially produced convulsions. Archives of Neurology and Psychiatry 1941; 46: 458-552.

Is referenced here, and described as an animal study. --Uthbrian (talk) 06:38, 22 January 2006 (UTC)

• Heilbrunn G, Weil A. Pathologic changes in the central nervous system in experimental electric shock. Archives of Neurology and Psychiatry 1942; 47: 918.

This is referenced by a testimony. Appears to be a study done with rabbits. --Uthbrian (talk) 06:38, 22 January 2006 (UTC)

• Ferraro A, Roizin L, Helfand M. Morphologic changes in the brains of monkeys following convulsions electrically induced. Journal of Neuropathology and Experimental Neurology 1946; 5: 285.

Not on Pubmed, probably due to time of publication. From title, appears to be a monkey study. --Uthbrian (talk) 06:38, 22 January 2006 (UTC)

• Ferraro A, Roizin L. Cerebral morphologic changes in monkeys subjected to a large number of electrically induced convulsions. American Journal of Psychiatry 1949; 106: 278.

Not on Pubmed, probably due to time of publication. From title, appears to be a monkey study. --Uthbrian (talk) 06:38, 22 January 2006 (UTC)

• Hartelius H. Cerebral changes following electrically induced convulsions. Acta Psychiatrica & Neurologica Supplement 1952; 77.

PMID 13007505. A study done with cats. --Uthbrian (talk) 06:38, 22 January 2006 (UTC)

Response: See below, on double standards. Just because an article is not online does not mean it is inaccessible. All of these documents are publicly accessible; I have read all of them. They require spending some time in a medical library..— Preceding unsigned comment added by 209.122.225.79 (talk • contribs)

Inacessible to me. Again it is not the responsibility of other editors to vette your material. Most would have just reverted. --John^DO|^{Speak your mind} 03:24, 24 January 2006 (UTC)

As far as I know, Wikipedia does not require that all knowledge, sources, and references, be available on the internet. That would leave out, OH, just about everything before 1993..— Preceding unsigned comment added by 209.122.225.79 (talk • contribs)

True.--John^DO|^{Speak your mind} 03:24, 24 January 2006 (UTC)

Yes, Doc, these are primary sources (unlike the plagiarized SG Report) and I have personally read all these references. Believe it. I have hundreds of pre-1950 articles, all in hard copy. (I could scan them in had I a scanner.)This was done by going to the library. .— Preceding unsigned comment added by 209.122.225.79 (talk • contribs)

Wikisource is a place to upload hard to find source materials. I believe libraries sometimes have scanners.--John^DO|^{Speak your mind} 03:24, 24 January 2006 (UTC)

I spent four whole days on the FDA Docket alone. You can do the same, before you dismiss the references as worthless or useless.— Preceding unsigned comment added by 209.122.225.79 (talk • contribs)

The FDA docket is not an acceptable citation reference to support a causality claim regarding permanent neurological deficit, unless that was one of their conclusions. The records I could find online indicated their conclusion was to not alter their regulations regarding ECT machines.--John^DO|^{Speak your mind} 03:24, 24 January 2006 (UTC)

Regarding citations

The citations thus far reviewed are a mixed bag. There are some interesting studies that indicate some possible long term anatomical effects. There are anecdotal reports, public testimony, and case reports. The most controversial assertions are not well supported.

• that the ECT machine industry monopolized funding - citation is court testimony
• every long term study has confirmed permanent memory loss - 3 citations, one unavailable, the second is here, and the third is a name/date. This statement seems to be original research.
• that at least one-third of ECT patients experience permanent memory loss - see text. This does not distinguish between retrograde memory loss which is acknowledged to be a common complication in the original text, and the implication of anterograde memory loss which tests have proven does not get permanently impaired.
• ECT causes permanent neuropsychological deficits - citation is a fda docket
• ECT causes a >30 point IQ loss - citations are 2 public testimonies and a book by an ect patient.
• that Anesthesia and muscle-paralyzing drugs increase the risks of the procedure and thus its mortality rate - of the 3 citations, one is not available, and the other 2 are name/dates.

In essence, the most controversial assertions are very sparsely supported. P.S. It is not customary for the other editors to have to vet sources. It is customary to do your own searches and provide links. --John^DO|^{Speak your mind} I doubt it 07:39, 22 January 2006 (UTC)

All material that does not satisfy WP:CITE may be removed. If you can't find a source, how are others supposed to? JFW | T@lk 08:27, 22 January 2006 (UTC)

Furthermore, these do not look like primary sources. These look like a wholesale copying of citations from other people's articles. Unless we are to believe that the anonymous user has personally referenced 10+ pre 1950 journals? --John^DO|^{Speak your mind} I doubt it 21:21, 22 January 2006 (UTC)

In the absence of any response from the anon, I will be reverting the changes while incorporating the supported assertions.

• Patients have issues with informed consent
• Data suggests ECT may cause anatomical changes in the brain of uncertain significance
• Memory loss should be clarified. Patients report regrade loss, which clinicians acknowledge.

--John^DO|^{Speak your mind} I doubt it 21:33, 22 January 2006 (UTC)

Anon has a good point regarding one thing. The original article was poorly cited, rife with name/date citations.--John^DO|^{Speak your mind} I doubt it 22:08, 22 January 2006 (UTC)

double standard here

There is clearly a double standard here. The original text does not meet Wikipedia quality standards; it is copied, word for word, from the Surgeon General's Report, a highly POV souce (I would like to post the criticism of the Report from major national organizations and news media, which would require typing them in since I have no scanner and cannot find links, but this is a very important point.) Is that allowable, or is it plagiarism? Which leads to the second problem. There were only THREE citations for the whole article before I came along, which means nearly all references were not cited! Yet no one complained, no one said they needed references, and there are still NO references for any of these cites. Does that not violate quality standards? I understand why the copier of this article could not provide references, because they were only copying the Report word for word and did not have the references, but that does not mean that they don't have to provide them! Meanwhile, while I have provided detailed citations, they have all been deleted, with commentary that is extremely inaccurate and biased IN FAVOR OF ECT, for instance, a peer reviewed article is said, without any foundation or evidence, to be "from an anti ECT Group" which is ridiculous! It is not. In short, any kind of sloppy article involving possible plagiarism or at least word for word copying without quotes, and without ANY citations, is acceptable----as long as it is favorable to ECT; however, anything thought, without any reason or evidence (and by WHOM?) to be anti-ECT (Whatever that means) doesn't need to have any citations at all!

No matter what your opinion on ECT (which should not enter into this) you should be able to see that there is a double standard here and an article that does not meet quality standards.

Either EVERY cite must be referenced or else deleted, or it must be permissible to cite without ANY references (which the majority of the article is).

The commentary on my references follows the same pattern, with articles in peer reviewed journals that have stood the test of time and been cited countless times being dismissed as not "real articles" apparently simply because someone thinks they aren't favorable enough to ECT.

Also, just because a source is not available online does not make it a "worthless" source. Someone called the FDA docket on ECT this. This docket predates the agency's putting its records online, and it is not online, but it is a public access document that anyone can read in hard copy. Please, by what standard are the FDA---every bit as much part of the government as the SG or NIMH---findings worthless? Only, apparently, by the standards that someone here thinks---without bothering to read it---that it's not sufficiently adulatory about ECT.

Again, the same standard must apply to everyone and every article. No edits and no article should be subjected to some kind of de facto sniff test by someone who obviously has an agenda to promote ECT. And why is this person in charge of this page, anyway?

I may not be the most computer literate person but I do know the literature on ECT.

The issue of financial conflict is critical. There are many ways to verify that authors have financial conflicts of interest which is absolutely material to evaluating their work. I have suggested three. Some, but very few, authors disclose their financial conflict (Abrams, cited here without any discussion of his ownership of a shock machine company, is one) but none disclose it within their articles themselves.

The vast majority of the cites which appear here without references (almost all that I did not put up) are by financially conflicted authors, and there is proof of that. 13 of 17 references in the ECT section of the SG Report (which was simply copied here word for word) are to financially conflicted authors. Why does Rudorfer appear so many times, who is he, some famous researcher? Not at all. He was the editor of this section of the SG report, and cited to himself more than anyone else on earth because he could. I realize you people did not know that. But now that you do, how could anyone call the Report a NPOV document that should be cited here word for word with claims of neutrality?

Does anyone here disagree that financial conflicts of interestare important for readers to know and for the authors of this article to tell them?— Preceding unsigned comment added by 209.122.225.79 (talk • contribs)

As is apparent here, I had already agreed that the article was deficient in citations and that it must be remedied. In fact, it was the last post before your message here and cleanup and citation needed tags had already been placed in the article. Find a good source for the financial conflict and it goes in, but the language has to be NPOV. And you should try to assume good faith, the reasons for the criticism of individual sources were given. And I assume you are speaking of me when you said someone who obviously has an agenda to promote ECT. And why is this person in charge of this page, anyway?. This kind of attitude is counterproductive and may constitute a personal attack which will significantly reduce your credibility here. No one here has any nefarious agenda. I am not a psychiatrist and do not use ECT, nor am I affiliated with any ECT company. I, like the other editors, am only interested in making this article accurate and NPOV. Frankly a number of your sources (video depositions, court testimonies, patient books) are not good citation sources to support medical claims in a scientific article. The documentation that I could find regarding the FDA docket revealed a conclusion that regulations regarding ECT machines would not be changed. This is not a reputable source to support allegations of permanent neurological deficit caused by ECT. And despite your allegations The commentary on my references follows the same pattern, with articles in peer reviewed journals that have stood the test of time and been cited countless times being dismissed as not "real articles" apparently simply because someone thinks they aren't favorable enough to ECT, the majority of your citations were deemed legitimate. Only 3 of your articles in peer reviewed journals [14] [15][16] were questioned as "not real articles", and the reasons were given, generally for lack of pubmed citation. And it is the responsibility of every editor including yourself to do a "sniff test" if someone starts doing massive edits of articles and includes information that is controversial and contrary to accepted knowledge. Frankly, the amount of effort that was expended to vette your sources was unusual, something you don't seem to appreciate. That effort should have been done by the editor inserting the sources. Typically articles are reverted until new additions are vetted. However, I do thank you for providing those sources, but I am troubled by your accusatory tone, and your instant reversion of the article despite good faith efforts to incorporate information from your sources.--John^DO|^{Speak your mind} 03:08, 24 January 2006 (UTC)

P.S. please sign your posts, it helps us figure out who is saying what.--John^DO|^{Speak your mind} 02:14, 24 January 2006 (UTC)

You found the discussion tab? Hurrah! :-) Kim Bruning 02:06, 24 January 2006 (UTC)

While it is encouraging that you are finally discussing matters, it is also troubling that despite repeated entreaties to discuss this matter, you reverted the material prior to engaging us in discussion. --John^DO|^{Speak your mind} 03:27, 24 January 2006 (UTC)

Editors,"vets", POV

Once again, I am new to all this. So please be patient. I am coming in and seeing so many inaccuries in the article, it was all I could do not to change it all at once!

Instead I took the one section that had been copied (or plagiarized, because there are no quotes) from the SG report, a very biased (pro-shock) POV document. There lies the problem, for some reason this article starts with a very strong POV, which no one is acknowledging because after all, they didn't write it, just copied it.

I don't understand how one person "edits" this, I thought we all did. Apparently there is someone who is a doctor who volunteered? Was chosen? to have final say over this article? How does that happen?

I am assuming he wasn't chosen because of expertise in ECT.

What is meant by "vet"? Is there a rule that this one person, the editor, has to read every reference? And does he get to judge them all by himself (highly problematic, in my opinion?)

Clearly this person is not the owner of a shock machine company---but I have been involved with ECT long enough to know that even rank and file doctors react very strongly to anything but the APA's party line on ECT. It is as if when you examine ECT closely, you are holding the entire enterprise of psychiatry up to scrutiny, and any "criticism" of ECT will bring it all down. This is not rational, but I've seen it enough to know it's common.

In any case, Dr. Editor, if there is a rule that you have to read every reference, it is not the case that any of mine are inaccessible to you. They are accessible to anyone. You can get them at a medical library; or in the case of the FDA, at the FDA; or in the case of court hearings or legislative testimony, by ordering the transcripts.

Thanks for clarification and your patience.

Doogs (anon)

The best available evidence

Perhaps I should take this a little slower, a piece at a time.

Every single "fact" we know or think we know about ECT is influenced by the research or lack of it. In the case of ECT, it is more the latter case.

There are some very critical aspects of ECT that simply have never been researched, and some that have been very inadequately researched, and this all relates directly to the financial conflicts of a few key men who have a lock on the research money.

(In my edit I did not say that these financial conflicts cause the lack of research, for instance, the dearth of long term studies; I said, quite accurately, that the time period when there have been no studies correlates with the time period when research money has been in the hands of men who work for the shock machine companies. This is not a POV statement, but a factual one.)

So, what do you tell patients, or the world in this Wikipedia, when formal research data simply isn't there? You tell them the data isn't there, and because these are such important things to know, you use the best available evidence that exists.

Take IQ. It is extremely important for patients and families to know whether ECT can permanently lower IQ. This has not been studied. However, what you can say, and what I did say, was that former patients have reported extreme (30+ points) loss of IQ, and that they did not only just say this, but they backed it up with neuropsychological testing, and that the some of the results of this neuropsychological testing have been submitted to the FDA, where they can be viewed by anyone by going in and reading the docket.

Is this "too anecdotal"? I cited testimonies given at formal public hearings, transcripts of which are available to anyone. I did not cite someone going on a talk show and saying, Oh, ECT lowered my IQ. In fact, I could have cited to Philpot on this point, because approximately 40% of ECT patients in their study reported that ECT lowered their intelligence; however, those patients did not, as far as we know, have formal IQ testing done, which the others did.

Until there is a study done, which in my opinion will not be done until (unlikely) someone wrests the available research money away from those who've had it locked up for 20 years, this is the best evidence we have, and it is important to cite to it.

Interestingly, there are two studies which incidently (as part of studying something else) mention IQ and claim to have tested it, but the scores of the patients were never reported, only means of the whole group, which makes it impossible to see whatever individual differences there were. However, it is possible to tell in one of these that pre ECT there was a patient who scored 127, and afterwards the highest score was around 100.

I think it is very important to keep the IQ part in, and use the best available cites that exist.

One is a "patient book", but remember, the APA does highly regard and recommend "patient books" in its ECT guidelines---as long as they are adulatory of ECT! They do not discredit books written by former patients or say they are unreliable sources. And this one was published by Random House, so one must assume author credibility.

FDA

I think it is important to add the FDA's official position to this article. I understand the FDA website is difficult to navigate.

FDA classifies the ECT machine, and therefore ECT, as Class III, high risk. This is the category for devices that have not been proven safe, meaning the benefits have not been shown to outweigh risks and there is unreasonable risk of injury or harm. (You can look up the meaning of Class III on their site.)

The change that they might have made, were pressured by the shock industry to make, and did not make, was to change the classification to Class II. This would have put ECT in the same category as a massage chair, just think about that! That is what the APA wanted.

The ECT docket, 40 volumes all of which I have read, contain the evidence that went into their making the decision to maintain the device in Class III.

In 1979 (I will get the cite from CFR when I edit the article) the FDA stated that the risks of ECT include brain damage and memory loss, and it has never retracted that statement.

Any objection to including the FDA classification in the article?

Doogs