Talk:Electroconvulsive therapy

From Wikipedia, the free encyclopedia
Jump to: navigation, search




What are the typical voltages used for this? I think that should be added to the article, perhaps under the 'equipment' section (where it does mention the typical current used). —Preceding unsigned comment added by (talk) 21:26, 30 March 2009 (UTC)

Its usually over 9kV. —Preceding unsigned comment added by (talk) 06:55, 7 May 2009 (UTC)

If the regulating factor is flow, and it is balanced somehow, at least mention the potential forces (volts) involved with this. The only way you could control the flow is by adjusting the resistance or force.... Msjayhawk (talk) 03:12, 26 January 2010 (UTC)

A number of parameters should be considered. In the article the Current and Power levels were statated. The Voltage can be determined by dividing the Power level by the Current level. However, just as important are electrical waveforms and frequencies (e.g. sine-wave/pulse), pulse durations, and currents. The currents and their waveforms have the greatest effect. Remember, a common static-shock can be as much as 20,0000 volts and be nothing more than an annoyance. —Preceding unsigned comment added by (talk) 15:57, 21 February 2010 (UTC)

Voltage is related to resistance of the human subject which is guessed at with an ohm meter before the procedure. Also there is the break down threshold in the material, as in once electricity starts to flow through a pathway the previous resistance drops dramatically. Very similar to lightning.--Mark v1.0 (talk) 13:15, 22 September 2013 (UTC)

bipolar manic depressive disorder cluster personality disorder[edit]

would this be help ful in these cases well they are for one person me ive tried many diffirent drugs and have little hope to be what pepole call normal

Wikipedia as a rule doesn't offer medical advice. But in all honesty, would you really want highly specialised medical advice from somebody randomly over the internet, of uncertain qualifications, who's unfamiliar of your complex circumstances and unable to evaluate you properly? I suggest you discuss medical decisions such as these with your psychiatrist for a more personalised, trustworthy, and intelligent answer. (talk) 17:01, 15 October 2009 (UTC)

He never said he was normal, lol SonicNiGHT 09:01, 27 August 2010 (UTC)

Status Epilepticus[edit]

I did not see this listed, but ECT is also used to treat status epilepticus. Is there any reason why this is not in the article? —Preceding unsigned comment added by Mkayatta (talkcontribs) 14:51, 22 July 2009 (UTC)

ECT is documented to be a CAUSE of non-convulsive status epilepticus. ECT has been used to treat other mental disorders or neuropsychiatric symtpoms as well, but they aren't all listed in this article. It's main uses are listed in the article. Danrz (talk) 04:43, 13 September 2009 (UTC)

ECT may induce a non-convulsive status and EEG monitoring is in place to catch that. However, status that happened all on it's own CAN be controlled with ECT as ECT itself increases seizure threshold. —Preceding unsigned comment added by (talk) 21:19, 23 October 2010 (UTC)

I removed the movies "A Beautiful Mind " and "Regeneration" from Fictional and semi-fictional depictions Character in A Beautiful Mind receives Insulin Coma Treatment and the treatment in Regeneration is not ECT but an electric current given through the mouth. —Preceding unsigned comment added by S. Belt (talkcontribs) 12:57, 19 November 2009 (UTC)

Mind Control?[edit]

Given the amount of controversy it seems placing this article under the category "Mind Control" would be comparable to creating a category titled "Beneficial and Harmless Psychiatric Treatments" and placing it alongside Mind Control and Human Rights Abuses. I can much more clearly see the argument for leaving it in the latter category but the term Mind Control seems strikingly biased to me. I'm going to be bold and remove it but if I am in the wrong I would like very much to hear why that is an appropriate label. (talk) 00:04, 27 November 2009 (UTC)

Only possible justification would be in regard to Ewen Cameron's use of ECT to depattern people in Montreal. For what it's worth, I think you're right to remove the categorisation though. Freekra (talk) 00:49, 27 November 2009 (UTC)

I wasn't aware of the categorization on this page, but there is a history of experimental use for this purpose. For example, the Montreal case mentioned above. Also, highly notable is the use by psychiatrist HC Tien. See here, and also here. And there's more. Read about its history in New Zealand, for example. So, at least from a historical and experimental perspective, yes, it's been used for this purpose. And as to other types of abuse, read about how it was forced on Chinese children recently because they were spending too much time on the internet. Danrz (talk) 02:16, 27 November 2009 (UTC)
Also, as its action remains unknown, it is still essentially an experimental procedure. I've created a category "Human experimentation in psychiatry" to which I've added this page. This category is not meant to equate to a moral judgement or condemnation of any particular practice but to be used when any procedure in psychiatry meets the criteria of being an experimental procedure.FiachraByrne (talk) 09:17, 8 March 2011 (UTC)
Did they use it during the MKULTRA years? I know there have been some people who have testified to some pretty extreme abuses from the program. Given that the CIA destroyed most of the documents of the project to protect themselves from criminal liability, if we can find victim testimony and include it, it would be relevant to the category. I think it would be folly to think that among the hugely illegal and unethical things that CIA did in the years of publicized mind control projects that ECT never crossed their mind. It may have been a conspiracy theorist that put it under this category, but the use of extreme experimental procedures in the pursuit of psychological control is well documented.Bloomingdedalus (talk) 19:58, 18 June 2011 (UTC)
Update -- I have found a source from the Indiana School of Medicine, Center for Bioethics which confirms that ECT was employed during MKULTRA, I have not thoroughly examined the main page to see if there is a reference to it's use in regards to this program or others is cited or mentioned, but it does justify the category of "mind-control" which makes no judgments as to the efficacy of ECT in achieving "mind-control" (whatever that constitutes): Bloomingdedalus (talk) 22:17, 19 June 2011 (UTC)

Electroconvulsive therapy (ECT) and Deep brain stimulation (DBS)[edit]

I wonder if Electroconvulsive therapy (ECT) should be linked to Deep brain stimulation (DBS) as both are used for the similar reasons (mental health) and involve the use of electricity. --Antidote 13:43, 9 April 2010 (UTC)

List of people who have undergone ECT[edit]

The inclusion of Dave Mustaine on the list appears to be in error. The interview used as a source has Dave Mustaine describing how he received "electric shock" therapy to increase the mobility of his arm after an injury, to make him capable of playing guitar again. This sounds like it was not ECT some sort of electrical stimulation procedure that would be performed on the nerves and/or muscles of the arm since it has nothing to do with the central nervous system and was not a psychiatric procedure. (talk) 00:51, 9 May 2010 (UTC)

I've removed him from the list. Per the citation, it sounds like he simply had TENS therapy to his arm, not ECT. --CliffC (talk) 21:35, 17 October 2010 (UTC)
I think it might be best to create a separate page listing people who have undergone ECT and link to it in the article.FiachraByrne (talk) 09:23, 8 March 2011 (UTC)

Too Long Label[edit]

I totally agree with this. I also get feeling that the article is so long in order to placate the anti-ECT agitators who would rather this article be their own soap box, no? (talk) 20:52, 17 October 2010 (UTC)


I think the ECT controversy is so important and so complex since there are multiple mechanisms of controversy that this should be its own web page or an extended one. —Preceding unsigned comment added by (talk) 20:45, 28 November 2010 (UTC)

Wikipedia doesn't generally encourage content forks until an article grows quite large, so as to keep all related material together. Right now the article doesn't seem that large. --CliffC (talk) 22:45, 28 November 2010 (UTC)
I actually think that this is a good idea given the article length and problems with its current structure. However, this should not be used as an opportunity to elide any controversial aspects of the treatment in the main article. These should be treated, but succinctly.FiachraByrne (talk) 09:20, 8 March 2011 (UTC)


I have an ancient dog-eared book written by psychoanalyst A.A. Brill in 1938. Here's what he had to say about this subject:

"A chronic schizophrenic may remain in a hospital for years in a state of indifference, but now and then he may suddenly act like a rational being. Sometimes a severe shock, such as an accident or illness which threatens his self-preservative instinct, brings the schizophrenic back to reality for a time. The latest form of therapy for schizophrenics is based on this very idea. I am referring to the insulin or, as it is called, the shock therapy, because the patient receives such a shock through the hypogycemia that for a time at least he gives up his phantasy world. But it matters little whether hypoglycemia cures or only produces a transient change; the fact that schizophrenics occassionally return to normality spontaneously and then relapse, and the fact that an accidental or experimental shock can drive them back to reality at least for a time, clearly shows that the psychotic, too, is not altogether detached from reality."

(*The Basic Writings of Sigmund Freud* [introduction] A. A. Brill, The Modern Library, 1938. pg.23-24.)

I have to wonder if modern medicine is beating its head against a wall in futile reductionist attempts to find physical explanations for a purely psychological phenomenon, even to the point where common sense is abandoned. Snud (talk) 23:13, 28 November 2010 (UTC)

Well, this isn't place to do that. Also, the quote you cite betrays your notion anyway. That's like a murderer showing a photo of him murdering while saying "You have to wonder why people murder, I don't get it." Why are you wasting space here? (talk) 06:20, 5 December 2010 (UTC)
I thought it was interesting. It made me think about something I never thought of before. Are you not interested in thinking about it? Isn't this a discussion page? Haven't I provided documented facts you didn't know before? I do realize that my information might be disturbing to the lambs, but I know you aren't one of those.Snud (talk) 05:56, 6 December 2010 (UTC)
Come to think of it, I'm getting tired of people preferring incomprehensible gobbledy gook reductionistic explanations for mental illness rather than emotions and drives. What's wrong with common sense, huh? Nowadays it seems that mental illness no longer exists; just nerve damage. It's so naive and simple minded I'm getting sick of it. You know, there are still no neurological, lab or genetic tests for any mental illness, and therefore no mechanical explanations for the efficacy of ECT, so please take YOUR foolish, la de dah objections elswhere!— Preceding unsigned comment added by (talkcontribs)
The quote you used was talking about insulin shock therapy, not Electroconvulsive therapy. If you don't know what hypoglycemia means, perhaps you should use a dictionary before including quotes irrelevant to topics. The physical underlies everything, which is why legitimate scientists look to the physical for a set of symptoms. The point of this quote is that the psychiatrist was intentionally putting someone in mortal danger to see if it would draw someone back to a "realistic" view of the world. That being said, 1938 is hardly "modern" medical practice, it's a rapidly changing field which has exploded in complexity and knowledge in the past 80 years. I do share your skepticism toward some psychological diagnosis, but there are also people who are very clearly and realistically affected by mental illness, if a man says he sees 10 foot tall snails following him, he's probably hallucinating. If you want to understand the truth and limitations of neurology vs. psychiatry, I suggest you start by learning the word "hypoglycemia" and continue studying from there. I have that exact edition of Freud, by the way, on my shelf: 1938, Modern Library, Basic Writings, introduction by Brill. The next place you should start is Martha Mitchell then get a solid neuroanatomy book and put down Freud for a while. Bloomingdedalus (talk) 20:13, 18 June 2011 (UTC)
As you say 1938 is hardly modern medical science, yet today we still use the terms and definitions they invented at that time like (psychotic). Penicillin had not even been used to treat syphilis a physical illness believed to be a mental illness. Today science can see the smallest thing and can not find a physical cause to mental illness. If science did find a physical cause, the illness would then be a Neurological disorder not mental illness. --Mark v1.0 (talk) 13:51, 22 September 2013 (UTC)

Stats for rates of administration of voluntary and involuntary ECT in the USA[edit]

There does not appear to be any recent stats (i.e. within the past 20 years) for the use of ECT on either a voluntary or involuntary basis for the US. Therefore, the surgeon general's statement on the rate of involuntary ECT use as "uncommon" is not simply ambiguous, but, I think, currently unsupported. I've changed the lead, citing what data I could find, to reflect this. Does anyone have any national data for the use of vol and invol ECT that could be added to the article?FiachraByrne (talk) 11:38, 24 February 2011 (UTC)

Any stats again on ECT usage worldwide or elsewhere would be appreciated. I know there are statistics for the England, Wales, Scotland and Ireland (republic of) and also Australia. Italy we know hardly has any ECT. Are there stats for any other jurisdictions? Could people post any sources on stats here. The US stats, which are a bit questionable anyway (based on clinicians recollection of how often they've used ECT) date from about 1988-89 I think. Other than Texas there are no current stats for the US. FiachraByrne (talk) 09:26, 8 March 2011 (UTC)
Roughly 6% of people (600 of every 10,000) suffer from major depressive disorder (ref 1, 2. In the United States, nationwide 5 in 10,000 people were treated with ECT, as of in 1995" (ref 3). This suggests that 5 of every 600 people with major depressive disorder undergo ECT; that's less than 1%. -- Niubrad (talk) 08:22, 31 August 2015 (UTC)

Article Lead Might Need a Rewrite[edit]

I think the lead for this article is impressionistic, defensive, and somewhat ideological. I think it could do with a rewrite including only material that has a solid empirical base. I don't think it should seek to champion or denigrate the procedure but simply to reflect what information there is out there on it, good and bad.FiachraByrne (talk) 13:28, 24 February 2011 (UTC)

I agree. I tried to clean up some of the more egregious problems. But the task of streamlining this is a bit daunting, especially considering the expected resistance.JohnDO|Speak your mind 05:00, 6 March 2011 (UTC)
Well, I suggest we just look at each statement in the article and see is it justified. For instance the statement that 1 million people receive ECT worldwide relies on a pretty weak source. I don't think that a simple statement by Larry Tye, a medical reporter, is sufficient to support this claim. Are there any real figures for ECT usage. 20:03, 6 March 2011 (UTC)
OK - I've removed unsubstantiated statements from the lead (e.g. numbers worldwide receiving ETC, etc). I've also reformulated statement that ECT is regarded as safe and effective stating that this is the view held by the majority of psychiatrists (which is supported) but that it remains a controversial procedure as reflected in popular opinion, legal restrictions on its usage, disputes within psychiatry and medical profession (and indeed other mental health professions) as to its efficacy and safety. Also that it has been recently decided by FDA to maintain it in Class III devices (highest risk). I think these additions are factual and balanced. There are other items I'd like to tackle in the lead - not least the general bias, also quite evident in the article, to treat ECT as if it were solely or predominantly an American phenomenon with passing references to the UK. But I think for now it is best to move on to the main body of the article. We need to think about which sections would make good sub articles. FiachraByrne (talk) 04:37, 8 March 2011 (UTC)
I think an obvious choice would be to create a new page entitled the History of electroconvulsive therapy and retain at most a paragraph or two -very tightly written and hitting on all the points pertinent to its present use and image - of the history of ECT. However, this will require the preparation of a decent article, incorporating the info here, on the history.FiachraByrne (talk) 09:14, 8 March 2011 (UTC)

Effects related to endorphine / mu-receptor stimulation?[edit]

Release of endogenous opioids following transcutaneous electric nerve stimulation in an experimental model of acute inflammatory pain., has it ever been considered that the affects of ECT may be mediated via the opioid system? (talk) 23:03, 18 July 2011 (UTC)

Unsupported assertion[edit]

This is an excellent presentation because it includes the failure of evidence.

Unfortunately, the opening description plainly violates the rules of science by asserting that electrovonvulsive therapy is "effective"

As the discussion, and literature, point out this assertion is plainly unsupportable. Rulesofscience (talk) 18:45, 13 August 2011 Rulesofscience (talk) 18:48, 13 August 2011 (UTC)

I don't see what you are complaining about. The article does not assert the ECT is effective, it only says that the majority of workers regard it as effective, and it gives a number of references to back up that assertion. Looie496 (talk) 17:42, 14 August 2011 (UTC)

ECT&DST as possible cause of brain damage[edit]

I am not normally a wikipedia editor so I don't know how to incorporate this information. Injuries have occurred because of use of ECT with DST (Deep Sleep Therapy) in Australia at Chelmsford Private Hospital that lead to hypoxia or anoxia in the patient. A judgment from the Australian NSW Supreme Court in which medical experts outline how in this case brain damage occurred. [ ] The relevant subheading is ECT as possible cause of brain damage in the judgment.

ECT has long been regarded as an appropriate physical treatment for some types of psychiatric illness, especially depression (cf. Bolam v. Friern Hospital Management Committee (1957) 1 WLR 582) although the situations accepted by the bulk of medical practitioners as appropriate for its use have been progressively circumscribed as various forms of psychiatric illness have become better understood, and as other, less traumatic, forms of therapy have been developed. It is a treatment which involves some well recognised risks. (Again I interpose to say that nothing I now say about ECT or the circumstances in which it was used in respect of the plaintiff is intended as in any way bearing on any question of liability which may ultimately need to be resolved; I expressly refrain from any comment on the question whether in the circumstances of this case, the administration of ECT and the manner of its administration were appropriate). ECT involves the sending of an electric charge through the brain and that has an effect on the oxygenation process to the brain. Dr. Phillips explained it, saying:-

"... it is certainly more than an instant. There are two parts to this. There is the actual moment of the electrical impulse, which will vary, depending on the machinery used and a variety of other factors, and respiration will be stopped momentarily then. That does not matter particularly. The patient then, and this is why ECT is used, the patient will then have an epileptic seizure. The first phase of an epileptic seizure is a phase whereby the patient goes into muscle spasm and during that phase, which can last from seconds to over a minute, respiration will cease. The patient then goes into the second phase of the epileptic seizure, which is a phase of contraction and relaxation of muscles, the characteristic, the lay idea of the seizure, and respiration will be disordered but will continue during that period. So it is the phase, the tonic phase, the tonic phase of contraction of muscles during which respiration ceases that is my concern in relation to anoxia."

The risk of anoxia during ECT being well recognised, usual practice according to Dr. Phillips (again without challenge or contradiction) is for the patient to be oxygenated prior to the actual electro-convulsion and as quickly as possible following the tonic phase of the epileptic seizure. There is no evidence that oxygen was given on occasions when ECT was administered to the plaintiff. — Preceding unsigned comment added by (talk) 14:02, 9 December 2011 (UTC)

Thanks, but testimony in a court case involving an unusual way of using ECT would not constitute an appropriate source for this article. The minimum we would need would be newspaper coverage, and discussion in an academic review paper would be much better. There is a large literature on the potential of ECT to cause brain damage, so we don't really need to be scraping for obscure sources. Regards, Looie496 (talk) 16:51, 9 December 2011 (UTC)

There are many articles that document brain damage, but you have to find them. Why is anesthesia used during ECT? Because some form of damage is going on. Thats why we feel the sensation of pain. has some references I hope to add to balance out the "goodness" of ECT.--Mark v1.0 (talk) 22:50, 31 January 2014 (UTC)

Removed badly written and un-sourced content[edit]

I removed the following text from the "Administration" section.

Informed consent is sought before treatment. Patients complain usually after the fact, that there was no truthful informed consent given. Databases collected over the years show this, has one, but there were others collected in previous decades. Perhaps the most troubling claim is that the current is actually higher, so ECT may be far more dangerous on the brain itself, which contradicts the claim that ECT is "highly safe." One can easily conclude that with enough shocks, and given the seizure threshold becomes more difficult to surpass, requiring often, higher doses of current to induce the seizure, ECT's cummulative damage in of itself, warrants it a brain damaging procedure. The ECT of "yesteryear" was routinely thought of as barbaric, brain damaging by top neurologists. So one huge question is if electircity is the same, or higher, how is it possible that ECT is at all safe, given the numerous anecdotal horror stories of memory loss, especially with increased frequency of shock. To further confound the debate, there is no talk of the actual voltage, current, or possible risk of any long term cognitive impairment, when many report permanent memory loss, sometimes up to a decade or more of autobiographical memory loss. There is also the troubling issue of court ordered or "forced ECT," survivors like Leonard Roy Frank have spent his life advocating against his forced 40 shock treatments that he believes destroyed his memory, personality, and caused life long trauma, and cogntiive diability, despite fighting to expose the utter misinformation, and coercion of this industry.
Patients are also made aware of risks and benefits of other treatments and of not having the procedure done at all. Depending on the jurisdiction, the need for further inputs from other medical professionals or legal professionals may be required. ECT is usually given on an in-patient basis.

It's very badly written with grammatical errors, spelling errors, un-encyclopedic language, "scare quotes", and is un-sourced. Onlynone (talk) 19:31, 1 January 2012 (UTC)

The article would be improved with a section discussing the possible placebo effect of its use and comparison with other ghastly medical procedures such as bloodletting. Without knowledge of its mechanism, ECT efficacy is dubious at best. Galfromohio (talk) 18:51, 30 June 2012 (UTC)

Unreferenced paragraph removed[edit]

I've removed the following unreferenced paragraph. It seems to be pushing a particular point of view and the claim that "ECT has also been lumped in the same categories as lobotomy and insulin comas, which are now universally regarded as dangerous and a form of torture" is particularly problematic and runs contrary to the rest of the article. Note also that I've removed the link to the ECT stories - the link was broken when I tried to access it.

Recent studies question if the risks of ECT outweigh any benefits mostly due to accounts of persisting memory deficits in former patients. There is also great concern over claims that the voltage and current is actually higher than in the days when ECT was considered a very dangerous treatment by most mainstream psychiatrists.[citation needed] ECT has also been lumped in the same categories as lobotomy and insulin comas, which are now universally regarded as dangerous and a form of torture. However, many survivors have reported severe cognitive problems including unexpected memory loss, numerous reports of years of life memories "washed away."[citation needed] Some reports and studies show patients losing a decade or more of memory (retrograde amnesia), and inabilities to retain new information, including loss of simple cognitive skills. There may be a huge disconnect over what the ECT industry calls a "highly safe and effective procedure" (claiming memory loss occurs only around the time course of treatments), and what many former patients report as a "memory eraser," a term frequently used by "bad outcome" ECT stories. Lack of truthful informed consent has also been a key issue troubling those patients, as well as doctors, who question the basic ethics behind ECT.[citation needed] Some personal accounts tell of devastation due to cognitive loss of former ECT patients. Julie Lawrence 2007 Personal ECT Stories HealthyPlace

Watermelon mang (talk) 21:18, 31 January 2012 (UTC)

POV and weasel words[edit]

i dont know how to make the cool markings that indicate a wiki principle needs attention. i added a wiki pov note to the sarcastic bit about the surgeon general and 'gross' damage. it's a medical term and explanation is warranted (thus i did not remove the sarcasm.)

the weasel words "small minority" are used in the first paragraphs about ect in other countries. if there isnt a citation i'm not sure where this comes from, though i am entirely willing to believe it.  :-) Tkech (talk) 23:25, 6 March 2012 (UTC)

Carol Kivler testimonial and mechanism of action[edit]

I have removed new content on the mechanism of action and an endorsement from Carol Kivler. Medical content on Wikipedia is strictly governed by guidelines and policies. I'm not sure the Kivler testimonial, or any testimonial, is appropriate for an evidence-based article. A very important guideline is Wikipedia:Identifying reliable sources (medicine). The source (Perrin et al.) for the mechanism of action content does not conform to that guideline.

Perrin et al., an fMRI study of ECT and frontal cortical connectivity in severe depressive disorder, is not appropriate for the claims the new text makes. Per the guideline I linked to above, we rely on expert reviews to put such results into context. This study can be mentioned once a review has done that, if the review gives it sufficient importance to warrant inclusion.

Also, it's important to be very precise in paraphrasing sources. The recent edit said, "The group's findings confirmed the hyperconnectivity hypothesis of ECT" which is stronger than the source's "The findings reported here add weight to the emerging “hyperconnectivity hypothesis” in depression..."

I'm not contesting the veracity of any of the content. But to be included in Wikipedia, the relevance and accuracy of all medical content must be supported by sources that conform to the above guideline - usually systematic reviews, graduate-level textbooks, national or international professional guidelines, or similar, that can be expected to accurately reflect the current scholarly consensus. --Anthonyhcole (talk) 07:41, 7 April 2012 (UTC)

Rollback of edit to "There is a significant risk of memory loss with ECT"[edit]

I used the rollback feature to change the last edit which added the word temporary to the following sentence: "There is a significant risk of temporary memory loss with ECT". I wanted to revert because that is not supported by that source - they emphasise, rightly or wrongly, permanent memory loss. I should have reverted the edit rather than use the rollback feature, however. FiachraByrne (talk) 22:04, 1 November 2012 (UTC)

Here's the diff [1] FiachraByrne (talk) 22:06, 1 November 2012 (UTC)

Actual examples should be removed[edit]

The topic says that "In 2012, CNN revealed a video of Andre McCollins at the Judge Rotenberg Center Center for behavioral therapy in Canton, Massachusetts being subjected to Electroconvulsive therapy.[145] The 18 year old boy's mother described Andre as being "tortured, terrorized and abused" by this type of treatment.[146]" This topic should be removed since it is not a video with an example of electroconvulsive therapy. If you go to the CNN reference in youtube (reference 145), Anderson Cooper states very clearly that it was a case of "aversive therapy" using SKIN SHOCK. So, again, nothing to do with electroconvulsive therapy, watch it at about two minutes of the video. [1] (Francisco) — Preceding unsigned comment added by Fguarn (talkcontribs) 18:26, 13 November 2012 (UTC)

I've removed it. Thanks for the information. Looie496 (talk) 18:49, 13 November 2012 (UTC)

Citing sources behind paywalls[edit]

"A 2011 paper in the Journal of Psychiatric Nurses Association reported that ECT was effective.[27]"

I can't access the article without paying for it, so I can't confirm that the paper actually supports ECT. In light of this problem, should the paper be cited at all?— Preceding unsigned comment added by Sonicsuns (talkcontribs)

Our sourcing policies don't require that free online versions of sources be available -- it's always good if possible, but often would mean that essential and highly reputable sources could not be used. In this case, though, that appears to be a very short opinion piece that doesn't really add anything of substance to our article, so I would be supportive of removing that line if that's what you would like to do. Looie496 (talk) 21:20, 19 March 2013 (UTC)
I think that is a strong and important statement. I don't think it should be removed. And yes, unfortunately this is a problem and WP:PAYWALL says that wikipedia does not guarantee ease in accessing sources. MidnightRequestLine (talk) 01:34, 20 March 2013 (UTC)

I hope an editor will make corrections to the "administration" section.[edit]

A few basic points: ECT is a treatment for severe episodes of major depression, mania, and some types of schizophrenia. No changes in medication are made prior to beginning treatment, with the exception of benzodiazapenes. Benzodiazapenes can interfere with the efficacy of ECT, so a patient may be tapered off prior to beginning treatment. However, if this will be counter-therapeutic, a benzodiazapene antagonist can be used at each ECT session. ECT is usually administered three times a week, on alternate days, over a course of two to four weeks. It is administered under general anesthesia, after which a muscle relaxant is given to control the seizure activity (the only seizure activity to the body is a clenching of the jaw, and a twitching of the foot [a tourniquet is placed around one ankle prior to the administration of the muscle relaxant]). The patient's EEG, ECG, and blood oxygen levels are monitored during treatment. The controlled electrical stimulus lasts from a fraction of a second to a maximum of six seconds. Over the past decade, unilateral ECT has overcome bilateral ECT as the treatment of choice, because it is associated with significantly less memory impairment.

Source: Duke University Medical Center, Department of Psychiatry — Preceding unsigned comment added by (talk) 23:10, 24 March 2013 (UTC)

Thanks for pointing out that the article could use more detail in this section. However for information of this nature to be added to the article, it must be supported by a published, reliable medical source, as per the WP:MEDRS guideline. The source provided is not useful in that regard. I will do some digging for sources and see what i can find.Jytdog (talk) 00:01, 25 March 2013 (UTC)
source gathering. First line is handled in "patient selection" section, not in administration section.

Snd line. Apparently there is little consensus on whether meds should be tapered or maintained. [1]:1885[2] As for reducing benzos, that is clinical practice, as is potentially administering a benzo antagonist, [1]:1879 as benzos increases the seizure threshold, but apparently the ECT treatment given can also be adjusted to compensate for that.[1]:1875 anesthesia and muscle relaxant are already covered in the administration section. duration of a given treatment, their frequency and duration of treatment overall are discussed here [1]:1882-1883 as is monitoring. location of electrodes is as you say[1]:1881. OK I will add this content to the article with these sources. Thanks again for the suggestion. — Preceding unsigned comment added by Jytdog (talkcontribs) 00:46, 25 March 2013 (UTC)

  1. ^ a b c d e Rudorfer, MV, Henry, ME, Sackeim, HA (2003). "Electroconvulsive therapy". In A Tasman, J Kay, JA Lieberman (eds) Psychiatry, Second Edition. Chichester: John Wiley & Sons Ltd, 1865–1901.
  2. ^ Haskett RF and Loo C (2010) Role of Adjunctive Psychotropic Medications during ECT in the Treatment of Depression, Mania and Schizophrenia J ECT. 2010 September; 26(3): 196–20
Sorry Jytdog - in fixing above comment (so full comment and reference would display) I wiped your original signing of the comment and had to replace it with the above template. FiachraByrne (talk) 02:47, 25 March 2013 (UTC)
Thanks for mixing my mistakes :) Jytdog (talk) 14:02, 25 March 2013 (UTC)

section of text for deletion[edit]

I was just reviewing the article for violations of WP:OR and was also fixing some citation needed tags when I came acrss this:

"There are recent animal studies that have documented significant brain damage after an electroshock series. For example, in 2005, Russian researchers published a study entitled, Electroconvulsive Shock Induces Neuron Death in the Mouse Hippocampus: Correlation of Neurodegeneration with Convulsive Activity. In this study, the researchers found that after an electroshock series, there was a significant loss of neurons in parts of the brain and particularly in defined parts of the hippocampus where up to 10% of neurons were killed. The researchers conclude that "the main cause of neuron death is convulsions evoked by electric shocks."[78] In 2008, Portuguese researchers conducted a rat study aimed at answering the question of whether an electroshock series causes structural changes in vulnerable parts of the brain.[79] According to the authors, "This study answers positively the question of whether repeated administration of ECS seizures can cause brain lesions. Our data are consistent with findings from other animal models and from human studies in showing that neurons located in the entorhinal cortex and in the hilus of the dentate gyrus are particularly vulnerable to repeated seizures." However, they question the applicability of their own research with respect to Electroconvulsive therapy in humans: "An important caveat of our results is that it is unclear to what extent they are relevant to the use of electroconvulsive therapy in psychiatry, because the protocol employed in this study is different from that used clinically. Evidence from previous studies (Gombos et al., [1999]; Vaidya et al., [1999]) and from our pilot experiments indicates that treating rats either with five to ten widely spaced ECS (at 24- or 48-hr schedules) or with two stimulations only 2 hr apart does not lead to loss of hippocampal neurons".[79]"

So, this should be deleted under WP:MEDRS. The content immediately above this part, discusses results in HUMANS describing both negative and non-negative effects on brain structure. The sources cited above are reviews. What we have here, are primary studies in animals, that are added together to lend extra WP:WEIGHT to the negatives side. This violates WP:MEDRS and should be deleted. I intend to do so, but because this is a big chunk I wanted to give folks a chance to comment.Jytdog (talk) 00:22, 26 March 2013 (UTC)

Agreed, and after four days without objection, I have removed it. Zad68 14:09, 29 March 2013 (UTC)
Thanks!Jytdog (talk) 14:22, 29 March 2013 (UTC)

Mechanism of Action[edit]

The mechanism of action section is terribly written. Whilst it is true that the definitive mechanism isn't known, there are several promising theories, which the section makes no mention of. Changes in serotonergic neurotransmission (e.g. 5-HT1A receptor increases'reductions), dopaminaminergic neuortransmission (Increases in HVA levels in CSF, decreased D2 receptor binding, increased D1 and D3 receptor binding), neurogenesis (BDNF and VEGF, and BrdU studies of neuorgenesis in animals). I don't know how to write stuff on wikipedia, but for someone who does, please look at recent(ish) reviews on the topic: The use of MST and ECT in Treating depression, ebmeier & Allan international review of psychiatry 23(5): 400-412 (2011). Merkl, A. et al. Antidepressant electroconvulsive therapy: mechanism of action, recent advances and limitations. Experimental neuorology 219: 20-26 (2009). Scott, A. Mode of action of electroconvulsive therapy. Advacnes in psychiatric treatment 17: 15-22 (2011).

The section needs to be better than this. Someone please make it so! — Preceding unsigned comment added by (talk) 11:20, 8 April 2013 (UTC)

Our articles on academic topics are in general very underdeveloped, so don't expect anybody to come along and do this. You should feel free to edit the article, or if you would like to suggest specific changes here on this talk page, I would be happy to react to them. Regards, Looie496 (talk) 15:51, 8 April 2013 (UTC)

Needed Citation in Adverse effects: Effects on memory[edit]

I suspect that the source for the Sackeim reference that has been marked-up "citation needed" is: Sackeim et al 2007, 'The Cognitive Effects of Electroconvulsive Therapy in Community Settings' Neuropsychopharmacology, vol. 32, pp. 244–254 (The full paper can be found for free here:

The uncited text in this section is a little vague and unencyclopedic but its substance appears well-sourced. Again, I can only speculate but it looks like the Wikipedia editor was trying to paraphrase the conclusion that appears on page 252 of the paper. Hope this helps. (talk) 07:33, 11 April 2013 (UTC)

Introduction Paragraph[edit]

The introduction paragraph has gone throught quite some re-edits. The latest change can be seen here:

The following is the disputed insert which is highlighted by bold: Electroconvulsive therapy (ECT), formerly known as electroshock, is a controversial psychiatric treatment in which seizures are electrically induced in anesthetized patients for symptom remission. Its mode of action is unknown.[1] Its efficacy has been questioned, with some meta-analyses illustrating a statistically significant, and positive, effect of the procedure while others suggest the procedure is no more effective than a placebo (see discussion following). The use of electroconvulsive therapy evolved out of convulsive therapy. Long before electric shocks were being administered to induce seizures, doctors were using other drugs and methods to induce seizures as a means of treatment for severe depression and schizophrenia. Today, ECT is used as a treatment for clinical depression that has not responded to other treatment, and sometimes for mania and catatonia.[2] It was first introduced in 1938 Italian neuropsychiatrists Ugo Cerletti and Lucio Bini, and gained widespread popularity as a form of treatment in the 1940s and 1950s.[3][4] (talk) 07:21, 16 September 2013 (UTC)

False gender gap removed[edit] — Preceding unsigned comment added by Stubborn Myth (talkcontribs) 05:25, 28 October 2013 (UTC)

Early history[edit]

The first sentence of History currently reads "As early as the 16th century, agents to induce seizures were used to treat psychiatric conditions". There are much earlier uses: there are well-attested records from the classical era by Pliny and Largus of physicians directing patients suffering from epilepsy or other conditions to touch electric rays in the hope of a cure. —BillC talk 10:05, 15 February 2014 (UTC)

Section mentioning Dr. Peter Breggin is biased[edit]

The section mentioning Dr. Peter Breggin is extremely biased and misleading. First of all, Dr. Breggin is not a critic of evidence-based psychiatry at all. One of his main points of criticism is that ECT has never had any evidence for its efficacy. There has never been a study comparing ECT with placebo that showed any benefit beyond 4 weeks. Dr. Breggin criticizes the use of ECT because of its lack of evidence. So to say he is a critic of evidence-based medicine is misleading and meant to bias the reader against his views. Finally, the statement that the scientific consensus does not agree is nothing more than an appeal to authority. The citations at the end of that sentence do not support this statement. The most comprehensive review of ECT can be found here: (talk) 19:10, 5 March 2014 (UTC)

Cancer and ECT[edit]

The Author wrote: that ECT could be administered; but,"with caution in those whose cancers are in remission or under control". I was curious if the Author could provide a reference for this? A friend took more than 10 ECT treatments and underwent a colonoscopy during her "treatment" only to find out she had a tiny cancer growing in her colon (like 3-5 mm in size). She informed her ECT "doctors" of her condition; they were sorry she had cancer; but, showed little concern for any possible interaction with ECT. She underwent one or two more "treatments" and when they resectioned her colon soon after, her surgeon discovered that her cancer had spread to her lymph nodes afterwhich she had to suffer with chemotherapy. Is this a coincidence or did her tiny cancer just randomly enter her lymphatic system? Even her oncologist characterized her cancer as "strange". (talk) 17:16, 24 March 2014 (UTC)

Sorry about your friend. interesting question about our article. you make a good point that the current text is not supported by any reference. I did some digging and as near as I can tell, the only kind of cancers relevant to ECT are brain cancers - they are a contraindication. I've corrected the text. Jytdog (talk) 17:34, 24 March 2014 (UTC)

10.1 Fictional Examples. A Beautiful Mind inaccurate[edit]

Tplew1 (talk) 01:42, 3 April 2014 (UTC) 10.1 Fictional Examples has the movie A Beautiful Mind listed. ect is not shown in this film. insulin shock therapy is shown. Tplew1 (talk) 01:42, 3 April 2014 (UTC)  Done, thanks! Jytdog (talk) 02:03, 3 April 2014 (UTC)

POV takeover of page- needs work being restored to NPOV[edit]

Hope people see this, the sections on adverse effects, efficacy, controversy over long term effects are all extremely biased, and deliberately any sources that are not pro ECT like "Journal of ECT". — Preceding unsigned comment added by (talk) 02:13, 13 May 2014 (UTC) you are clearly new to Wikipedia. You need to be more specific, and back up what you say with reliable sources, as we define reliable sources at Wikipedia. Please read WP:VERIFY and WP:MEDRS. This is not a forum to discuss views on ECT - this is a page to discuss improving the article, according to Wikipedia's policies and guidelines. I don't intend to be mean, but there is a rational foundation for what we do here. 02:33, 13 May 2014 (UTC)
OK, why is research like Peter Breggin and Harold Sackheim nowhere to be found in the article? Here's his wikipedia entry. As you can see, he's not some schmuck, and is actually a proponent of ECT. Could we please consider mentioning his 2007 research under the Adverse Effects section? — Preceding unsigned comment added by (talkcontribs) 07:17, 13 May 2014‎ (UTC)
above, i asked you to read WP:MEDRS. What that says, is that we don't use what we call "primary sources" in health related articles; we rely on reviews and statements by major medical and scientific bodies. btw, if you look at the section on adverse effects on memory and the conclusions of the 2007 primary source you cite, you will see that reviews have absorbed Sackheim's findings and that those findings - that sine wave stimulation and bilateral electrode placement were both associated with bigger problems - are in the article.Jytdog (talk) 11:51, 13 May 2014 (UTC)\\

Negative patient reports[edit]

Numerous patients have reported that they feel, rightly or wrongly, that they were damaged, sometimes severely, by ECT. There is one book published by Rutgers University Press, and another by Random House, on this topic. They do not purport to be giving medical analysis; they are reporting their own experiences. (The authors themselves received ECT.) Wouldn't it be more honest to mention these books and say what is wrong with them, if in fact they are defective? Why are negative patient reports not allowed? The following were removed after I added them: Prof. Linda Andre, "Doctors of Deception: What They Don't Want You to Know about Shock Treatment," Rutgers University Press, 2009, ISBN: 0813544416 Jonathan Cott, "On the Sea of Memory: A Journey from Forgetting to Remembering," Random House, 2005, ISBN: 1400060583 "The Electroshock Quotationary," ed. Leonard Roy Frank, 2006,, retrieved 2014-08-17 "ECT = Intentional Brain Damage," The Experience Project,; retrieved 2014-08-17 The last two are from less verifiable sources, but that people are making these comments alarm me. That they cannot be mentioned in the article alarms me more.deisenbe (talk) 02:40, 18 August 2014 (UTC)

If negative patient reactions to the treatment are indeed a significant complication of the treatment, that will be reported in the secondary literature and can be included here. We cannot possibly include mention of every individual who came away with a negative view of the treatment, just like we cannot possibly include mention of every positive story. Blogs and self-published materials like essays are primary sources for the views of the authors and secondary sources would be required to establish that the use of those primary source complies with WP:WEIGHT. The article already has a large section on adverse effects (although the sourcing could be improved) including memory loss and brain structure, please read through that and see if your concerns aren't already covered in the article. Zad68 02:10, 18 August 2014 (UTC)
Deisenbe please assume good faith. We are a community made up of lots of different kinds of people which means there are disagreements. We talk them through. Please change the section header. thanks. Jytdog (talk) 03:14, 18 August 2014 (UTC)

I must admit that there are also on the Internet first-person reports of patients who believe they were much helped by ECT.deisenbe (talk) 03:36, 18 August 2014 (UTC)

 :) Thanks for changing that. Yep, people say lots of things and importantly, experience a lot of things. But we want this article to be science-based, not anecdote-based. So we rely as much as we can on statements by major medical and science bodies (Like the NIH in the US or the NHS in the UK) or by good reviews published in the scientific literature. Those kinds of sources help us get as close to "truth" at any given time as we limited humans can... thanks again for talking. Jytdog (talk) 04:21, 18 August 2014 (UTC)

Use of uncommon words[edit]

I have changed the word "efficacious" to the word "effective". It is only a minor edit but I think this could be an indication that there may be other issues like this within the article. There was also the word "efficacy" but I left that in.

Wikipedia is supposed to be wide reaching. I am of the school of thought that says that commonly used words should be used where possible in any informational writing.--Hypernator (talk) 19:06, 29 September 2014 (UTC)

I came back to this because I felt that I had used an insufficient word replacement. Instead of replacing the word "efficacious" with the word "effective" I have expanded the sentence. I have now written the whole dictionary definition for the word efficacious into the sentence. It is not too long but, most importantly, it makes it far easier for a layperson to understand what is being said now. The word "efficacious" does not seem to be commonly used.--Hypernator (talk) 15:42, 2 October 2014 (UTC)


I wonder if this article is sufficiently balanced? I'm no Wikipedia expert but it generally reads as very pro-ECT. Any evidence which does not support the use of ECT is buried in the middle of sections. And the 'Controversy over long-term effects on general cognitiion' section has barely a mention of opposition to the view that ECT is safe and effective. I think Read and Bentall's review could be mentioned again here:

I'm not advocating a complete overhaul of the page, I thought it was an interesting read. However, the tone of positive certainty left me feeling uneasy. Psychiatry has a chequered history, having evolved over the years through a lot of trial and error. Although there are a range of useful ideas and treatments it is important not to fall for the lure of simple answers, when the evidence base shows mental health is far from simple.

I wonder if perhaps a Criticism section could be created, separate from adverse effects, for clarity? (talk) 10:36, 4 December 2014 (UTC)

The specific concerns you are bringing up deal with how much WP:WEIGHT or emphasis to give to each viewpoint. In this case, any discussion about "pro" or "anti" anything needs to be sourced to reliable sources, in this case our guideline for medical sources for medical claims. If the majority sources are "pro" ECT, then we are too. We do not give equal validity to all positions. I do not like criticism sections, and prefer that any critiques be incorporated into the article. Yobol (talk) 17:31, 4 December 2014 (UTC)

Alleged copy vio[edit]

I put in the following:

[1][2] In 1785, the therapeutic use of seizure induction was documented in the London Medical Journal.[3] As to its earliest antecedents one doctor claims 1744 as the dawn of electricity's therapeutic use, as documented in the first issue of Electricity and Medicine. Treatment and cure of hysterical blindness was documented eleven years later. Benjamin Franklin wrote an electro static machine cured "a woman of hysterical fits." G.B.C. Duchenne, the mid 19th century "Father of Electrotherapy," said its use was integral to a neurological practice.[4]

In the second half of the nineteenth century, such efforts were frequent enough in British asylums as to make it notable.[5]

  1. ^ A History of Mental Institutions in the United States which says electrostatic machines were used in 1773
  2. ^ Electroconsulsive Therapy – A History using date of 1746
  3. ^ Rudorfer, MV, Henry, ME, Sackeim, HA (2003).
  4. ^ Wright, Bruce A. M.D. "An Historical Review of Electro Convulsive Therapy". Jefferson Journal of Psychiatry: 66–74. 
  5. ^ Beveridge, A. W.; Renvoize, E. B. (1988). "Electricity: A History of its use in the Treatment of Mental Illness in Britain During the Second Half of the 19th Century" (PDF). British Journal of Psychiatry: 153, 157–162. Retrieved 28 December 2014. 

This is all paraphrase. If you have an issue, please discuss it here. 7&6=thirteen () 18:31, 28 December 2014 (UTC)

thanks for removing the copyvio from this version of your edit. Jytdog (talk) 19:04, 28 December 2014 (UTC)
I apologize. No copy vio was intended. I am glad we have come to a consensus. Best regards. 7&6=thirteen () 19:06, 28 December 2014 (UTC)

edit warring over content based on outdated review[edit]

IP editor added content based on an old review, which I removed on the basis of MEDRS, as our article already cites newer reviews. The IP editor has been re-inserting it, not providing a response to the violation of the guideline, for example here: dif. Per WP:BRD the burden is on the IP address to open a discussion. I have gone ahead and done it. IP, please explain how the content you want to add is OK per WP:MEDRS. Thanks. Jytdog (talk) 17:12, 16 February 2015 (UTC)

ECT mania addition[edit]

I think it is critical to indicate that ECT should only be used to treat mania AFTER at least one trial of psychotherapy has been conducted. — Preceding unsigned comment added by Ahuelsman (talkcontribs) 19:46, 29 March 2015 (UTC)

 Done. OK? Jytdog (talk) 20:01, 29 March 2015 (UTC)

Edits under "Usage"[edit]

Electroshock therapy has mass versatility and is performed on approximately 100,000 people a year. Although it is more common in older patients and in women, it has the capability to be used across all age spectrums, including in children. In addition, it can also be administered to pregnant women who can't take anti-depressants and to patients who have serious medical problems/illnesses. ECT has the vital function of getting people who are acutely suicidal out of that desperate state [1]

References ^ Fawcett, Kirstin.[1], "Electroconvulsive Therapy: What it is, How it Works and Who it Helps." U.S. News Health, October 29, 2014.

These changes will make the eliminate the original first line under "usage" and make it sound more scholarly and increase clarity. It will also add the broad overview of the usages of ECT in women, wide age spectrums, and patients with medical problems; this is gone into more depth in the sections "United states" etc. but would be useful in the usage section. The addition of the concluding sentence is also new information that is key to include under usage. Lewilson95 (talk) 20:04, 29 March 2015 (UTC)

that source fails WP:MEDRS - we cannot use it for content related to health ( like what ECT can and cannot be used for) Popular media is OK for some things, as described in the section on that in MEDRS. Jytdog (talk) 20:20, 29 March 2015 (UTC)

I don't understand why this information cannot be used. I am an undergraduate student- can you explain how this is not a reliable source? Lewilson95 (talk) 14:04, 31 March 2015 (UTC)

Thanks for writing. Did you read WP:MEDRS? thx Jytdog (talk) 14:07, 31 March 2015 (UTC)

Header Photo?[edit]

Can we please add a header photo? One that might show a person enjoying the procedure? All the pictures we have so far are historical, but it would be nice to see this topic further developed with a simple picture at the top of the page. I'd like for somebody looking into this therapy article to see that it is a modern procedure and that it is not as scary as the current historical pictures depict. — Preceding unsigned comment added by Kjk5182 (talkcontribs) 20:48, 5 April 2015 (UTC)

I very much doubt that anyone 'enjoys' ECT. And as for a picture, even if one were available (we rely on volunteers uploading images, and can't simply produce them on request), there are clearly issues of confidentiality involved in showing someone undergoing a psychiatric procedure - per the Wikipedia:Image use policy we would require the consent of the individual before using such an image. AndyTheGrump (talk) 21:07, 5 April 2015 (UTC)
I would consent as the subject, but when I asked for permission to have myself photographed undergoing ECT, my request was denied by the hospital legal department due to "liability issues". Since the procedure would involve at least 5 individuals besides myself (an anesthesiologist, their assistant, a doctor, a nurse, and of course a photographer) whose consent would also be required, I assume that they expect more than a simple verbal request. I have neither the expertise nor motivation required to write a legally binding document protecting the confidentiality and liability of all involved, but if someone were to contact me with a link to an appropriate public domain document that could be filled out by myself and others then presented to hospital legal staff, that might be enough. I agree that a more accurate and contemporary photo would improve the article. In my experience it is not as visually striking of a procedure as one might imagine, most closely resembling the typical use of general anaesthesia with ventilation provided via ambu-bag instead of intubation (or as I personally describe it, "like surgery, but without the surgery"). - Syd (talk) 21:07, 21 April 2015 (UTC)

Additional famous persons[edit]

I believe the 'Famous cases' section needs a bit more information in order to provide readers with sufficient information. A very notable person who has undergone ECT is Sherwin B. Nuland, award-winning author and surgeon. [1] Kyliempaul (talk) 01:30, 19 April 2015 (UTC)kyliempaul

Personally, I can see little merit in a 'famous persons' section at all - it can only ever consist of random anecdotes. AndyTheGrump (talk) 01:51, 19 April 2015 (UTC)

I think since ETC is such a misunderstood topic (due to portrayal in film), including famous persons who have undergone ETC would be beneficial. I know when I first read the article, I found the 'Famous cases' section to be very interesting.Kyliempaul (talk) 14:32, 19 April 2015 (UTC)kyliempaul

edits undone - claimed that they were not relevant, amount of electricity ECT[edit]

I tried to add a paragraph with a simple calculation to give an overview of the amount of voltage that is usually used with ECT. The edit was rather quickly reversed and it was claimed it was not 'relevant'.

I don't understand how this can NOT be considered relevant. In everyday life typically voltage is what people are familiar with not watts or ampere. Adding the voltage contributes to a better understanding. Generally when talking about electricity we rarely describe it as a relation between watts and ampere. The average reader will be far more familiar with volts. The current form is rather cryptic and I would guess many will not find it too useful or insightful.

Please see below of an overview of the edit: - old version:

typically, the electrical stimulus used in ECT is about 800 milliamps and has up to several hundred watts, and the current flows for between one and 6 seconds.[1]To put that into perspective, according to Ohm's law a current of 800 milliamps and a power of 100 watts corresponds to a voltage (V) of 125.

new version:

Typically, the electrical stimulus used in ECT is about 800 milliamps and has up to several hundred watts, and the current flows for between one and 6 seconds.[1] -

Any thoughts on how one could give a better overview of the amount of electricity that is used with ECT? On the internet one can read about various unsubstantiated claims ranging from extreme doses to mild electric currents. Personally I doubt that in the current form a reader will be able to get a better understanding regarding this unless they do some conversion of the above numbers or a reliable source mentioning voltage is cited.

The claim that I failed to demonstrate relevancy is a logical fallacy and frankly doesn't make any sense at all.

Let's assume the following:

1. The entire paragraph mentioning watt, and milliamps is irrelevant. Then why is it there in the first place and was not deleted by the people claiming non-relevance?

2. The paragraph is indeed relevant. (I don't think any reasonable person would argue against this) If it is relevant how can converting the numbers to a more understandable form not be relevant? I don't add any new information. I just make the present information more readable and understandable. I don't think anyone would argue that milliamps and watts give the average person more information than volt does.

In the talk section there are at least several people stating the electricity such as volt should be mentioned and the amount of electricity should be in a more understandable form. Not surprising since almost everyone would have to think hard what the current information actually could mean. A simple conversion does solve this problem while leaving the actual information unchanged.

My edit is as relevant as the numbers that I convert.

If they aren't relevant why haven't they been deleted yet?

The answer is of course because they are relevant!

The could be other arguments against my edit. I would welcome any feedback or suggestions how to improve it. Relevancy certainly isn't the problem here.

  1. ^ a b Lock, T (1995). "Stimulus dosing". In C Freeman (ed.) The ECT Handbook. London: Royal College of Psychiatrists, 72–87.
— Preceding unsigned comment added by (talk) 14:55, 17 June 2015 (UTC) 
You have cited no source demonstrating that your calculation is relevant, and you seem to have a fundamental misunderstanding of electricity - voltage is not a measure of the 'amount of' anything, other than potential difference. A typical static discharge (e.g. caused by earthing oneself after walking over a nylon carpet) may result from a potential difference of 20,000 volts or more. [2] You aren't putting anything 'into perspective', you are merely adding a number that you appear not to understand the meaning of. AndyTheGrump (talk) 18:17, 17 June 2015 (UTC)

Hello thank you for the reply. I understand what i wrote about electricity. I have used informal language here and called it "amount". This has nothing to do with my edit. From what you have written about electricity you don't seem to have an understanding of it. It is very clear from the context that the 20,000 volt discharge that you mentioned is indeed irrelevant here.

Adding voltage IS certainly very helpful and makes the paragraph more understandable for the average reader.

Please see other related medical wikipedia articles and note how they do use voltage. It is what you would expect. Or is this also irrelevant? Please tell me why it is relevant there and not here? As I stated before it doesn't make any sense. Simple calculations are not original research. You have cited no source why it is irrelevant. (The 20,000 volt example has nothing to do with this case) Similiar medical articles are using voltage and you can not cite a source why this one shouldn't. — Preceding unsigned comment added by (talk) 18:45, 17 June 2015 (UTC)

Wikipedia articles are based on sourced content. Cite a source. AndyTheGrump (talk) 19:04, 17 June 2015 (UTC)

Wikipedia does allow simple calculations. I don't need a source for that.

quote: ---Any relatively simple and direct mathematical calculation that reasonably educated readers can be expected to quickly and easily reproduce. For example, if given the population and the size of a specific area, then the population density of that area may be included.

— Preceding unsigned comment added by (talk) 19:22, 17 June 2015 (UTC) 
Unless you can cite a source demonstrating that voltage is relevant, it doesn't belong in the article, end of story. AndyTheGrump (talk) 19:35, 17 June 2015 (UTC)

So it is wrong just because you say so because it is your personal opinion?

I don't need a source that says voltage is relevant just like no one needs a source to convert celsius to fahrenheit or to use km or miles. These are used in everyday life. I don't need to prove that they are relevant.

Can you cite a source that says voltage should not be used in an electro-stimulation medical context? There isn't any.

Please refer to the link above:

quote-- Any relatively simple and direct mathematical calculation that reasonably educated readers can be expected to quickly and easily reproduce. For example, if given the population and the size of a specific area, then the population density of that area may be included. ---

What I did was perfectly legitimate. Or do I need to prove in the above example that population density is relevant and useful before adding it? — Preceding unsigned comment added by (talk) 20:15, 17 June 2015 (UTC)

External links modified[edit]

Hello fellow Wikipedians,

I have just added archive links to one external link on Electroconvulsive therapy. Please take a moment to review my edit. If necessary, add {{cbignore}} after the link to keep me from modifying it. Alternatively, you can add {{nobots|deny=InternetArchiveBot}} to keep me off the page altogether. I made the following changes:

When you have finished reviewing my changes, please set the checked parameter below to true to let others know.

YesY An editor has reviewed this edit and fixed any errors that were found.

  • If you have discovered URLs which were erroneously considered dead by the bot, you can report them with this tool.
  • If you found an error with any archives or the URLs themselves, you can fix them with this tool.

If you are unable to use these tools, you may set |needhelp=<your help request> on this template to request help from an experienced user. Please include details about your problem, to help other editors.

Cheers. —cyberbot IITalk to my owner:Online 04:45, 28 August 2015 (UTC)

Little mention of few high quality studies of efficacy for depression or suicide - ignores critical review[edit]

Electroconvulsive_therapy#Efficacy (for depression) mentions supportive 2003 and 2008 reviews but ignores the 2010 Read & Bentall review which finds the few high quality (randomised/blinded placebo controlled) studies do not support efficacy for depression or reduction in suicide. The Read and Bentall review is already cited twice but could be used much more widely to update this article - or has there been an effective rebuttal of its conclusions ? - Rod57 (talk) 12:53, 20 August 2016 (UTC)

The 2010 Read & Bentall paper has been discredited by at least one source. McCall et al[1], referring to this paper (reference #9), state:

"...evidenced-based mainstream summaries of [ECT's] mechanism have been lacking, while evidence-poor papers with an anti-ECT agenda have suggested that the mechanism of ECT is through brain damage (9, 10) or via placebo effects (11). These theories are wrong, and join a long list of discredited theories of ECT's mechanism."

Some will find further reading of McCall to be an "effective rebuttal", while others might refer to the lack of sources citing this review article. On the other hand, while somewhat dated, a 2003 Cochrane Review of ECT for depression in elderly does cite insufficient controlled evidence in this population. I do note that Cochrane has a Protocol for a systematic review of ECT for depression, but this has not yet been completed. Drdaviss (talk) 17:51, 20 August 2016 (UTC)
  1. ^ McCall, WV (2015). "Searching for the Mechanism(s) of ECT's Therapeutic Effect". Journal of ECT. PMC 4695970Freely accessible. PMID 24755719. 
Thanks for responding. It looks like McCall is saying R&B is evidence-poor concerning the mechanisms rather than the efficacy - it doesn't seem to rebut R&B's data selection or conclusions. Can you see anything in R&B that is wrong or unsupported ? I expect that R&B would be ignored (eg not cited) by people who's careers it doesn't support but that doesn't make it a biased or incompetent review. Is there a later review of placebo controlled trials that discusses it ? - Rod57 (talk) 11:11, 25 August 2016 (UTC)
Rod57, Read and Bentall's review is actually cited by several other articles. Including these four:
And Google Scholar says the review is cited by a whopping 76 articles!
Don't listen to Drdaviss. Christopher James Dubey (talk) 06:06, 7 September 2016 (UTC)
One sentence in one paper really doesn't "discredit" an entire other paper, no matter how much the authors think so, especially when it makes such a brief criticism with little reasoning to support that criticism and no citations of the actual words of the article it criticizes. I highly suspect this Wikipedia article on ECT has been monitored by people working in support of the ECT industry, but since I can't pinpoint any specific user conflicts of interest, I'm not going to make any assertions right now. Read and Bentall's review is much longer than the article by McCall et al that criticizes it, plus it cites a much larger number of sources. I used to edit this Wikipedia article about eight years ago and I have seen how much has been removed, including a larger citation of Read and Bentall's review. Many sources have been wiped out. While Read is certainly biased against ECT, it should also be noted that The Journal of ECT is itself very biased in favor of ECT. Even this Wikipedia article currently notes that Dr. Charles Kellner is "a prominent ECT researcher and former chief editor of the Journal of ECT." Kellner has written and spoken many times in favor of ECT, while downplaying any potential risks/harms. Christopher James Dubey (talk) 00:34, 4 September 2016 (UTC)
By the way, I am an ECT survivor. I will openly admit my bias. But I have been following the scientific and ethical debates over ECT since about 2006 when my involuntary ECT ended. I have had limited contact with John Read. I'm in the activist circles that include him. I can answer questions about how things have developed in the controversy in recent years. I can help people look up things about this and find sources. Christopher James Dubey (talk) 00:46, 4 September 2016 (UTC)

Regardless of whether you admit your bias or not, if the pro-ECT sources can't be trusted because they show bias, then you must also be ignored for the same reason. Bias is bias. Having an actual background in psychology, with a degree in same, The majority of the evidence I've seen shows that it can be quite beneficial for a short list of intractable mental disorders. That the fact still is a bit unusual to me thirty plus years after first being exposed to the data (in university) shows that I do not have any sort of bias in favor. I do NOT believe that it should be forced upon anyone absent informed consent. Speaking for myself, having suffered with major or minor depression most of my life, the one period where I actually felt optimistic, useful, valuable, without taking any sort of antidepressants was after an involuntary grand mal seizure brought on by two prescription meds that contraindicated each other, caught by neither the physician nor the pharmacy. The remission started a few days after and lasted for several weeks. And it was not an imaginary phenomenon. I go back and read my Facebook posts from the period and they're almost comically upbeat, a marked contrast to my usual sober self. And a marked contrast to posts made just a few days or a week before the seizure. Honestly, it never occurred to me to wonder why exactly I was feeling that way for at least couple of weeks. I'd forgotten completely about what I'd learned about the history of ECT--it arose out of a simple observation, across a couple of centuries, that people who suffered from severe melancholy or depression, who also suffered from a seizure disorder, often experienced a remission in the depression following a seizure. Until I suddenly remembered one day and had a serious head-spinning WTF? moment wondering if I had actually learned that. I confirmed it with a little research; I had indeed learned it in college and it had an additional thirty years of evidence to back it up. Though I'm now open to the idea, I myself have not undergone ECT. I've been talking to psychiatrists about it for several years following the involuntary seizure I had, and have found them uniformly cautious in the extreme about the idea. Every one I've spoken with, and that's more than ten, accepts it as a completely valid and often successful medical intervention for some patients, but not the first arrow to reach for in the quiver. I'll add this: some really boneheaded drugs or other interventions have been approved for use in medicine, and had to be yanked back out of the field when harm became apparent. And pretty much every single modern one has ambulance-chasing lawyers circling it like hyenas eager to bite off a few million dollars or so. Where are the hyenas circling the manufacturers of the ECT equipment or doctors who use it? The primary difference between ECT and those other interventions is that it's a lot harder to discredit something that's been under close observation for a couple hundred years. You make ECT sound like Egas Moniz riding around in the Leukotomy Wagon doing house calls with an ice pick in his back pocket. (And if you don't know who that is, or the difference between a lobotomy, leukotomy, or lobectomy, you might be out of your depth here). Speaking solely for myself, if my depression ever worsens to a degree I can no longer live with, I will undergo ECT if my shrink prescribes it, with little worry of harm.

I'm just going to go out on a limb here, and say I'm sorry: but your personal experiences don't make a dime's worth of difference in terms of the article. I personally would be willing to have a frontal lobotomy myself at the moment. But this is not supposed to be a forum, and our feelings and experiences don't matter when it comes to this Wikipedia article. Alt lys er svunnet hen (talk) 09:18, 3 November 2017 (UTC)

External links modified[edit]

Hello fellow Wikipedians,

I have just modified 3 external links on Electroconvulsive therapy. Please take a moment to review my edit. If you have any questions, or need the bot to ignore the links, or the page altogether, please visit this simple FaQ for additional information. I made the following changes:

When you have finished reviewing my changes, please set the checked parameter below to true or failed to let others know (documentation at {{Sourcecheck}}).

YesY An editor has reviewed this edit and fixed any errors that were found.

  • If you have discovered URLs which were erroneously considered dead by the bot, you can report them with this tool.
  • If you found an error with any archives or the URLs themselves, you can fix them with this tool.

If you are unable to use these tools, you may set |needhelp=<your help request> on this template to request help from an experienced user. Please include details about your problem, to help other editors.

Cheers.—InternetArchiveBot (Report bug) 06:56, 22 December 2016 (UTC)

External links modified[edit]

Hello fellow Wikipedians,

I have just modified 2 external links on Electroconvulsive therapy. Please take a moment to review my edit. If you have any questions, or need the bot to ignore the links, or the page altogether, please visit this simple FaQ for additional information. I made the following changes:

When you have finished reviewing my changes, you may follow the instructions on the template below to fix any issues with the URLs.

You may set the |checked=, on this template, to true or failed to let other editors know you reviewed the change. If you find any errors, please use the tools below to fix them or call an editor by setting |needhelp= to your help request.

  • If you have discovered URLs which were erroneously considered dead by the bot, you can report them with this tool.
  • If you found an error with any archives or the URLs themselves, you can fix them with this tool.

If you are unable to use these tools, you may set |needhelp=<your help request> on this template to request help from an experienced user. Please include details about your problem, to help other editors.

Cheers.—InternetArchiveBot (Report bug) 03:16, 19 September 2017 (UTC)

One vital fact is missing[edit]

I saw Cuckoo's Nest like a lot of other people. Poetic license be damned, that one book and movie has done great harm to those who could have benefited from ECT, but were frightened away by that movie. Like so many others, I accepted as fact with no evidence the idea that ECT was brutal and inhumane. I mean, electrocuting someone's brain and turning them into a flopping vegetable, that had to be terribly harmful, right?

I have a BS in Psychology. To earn that degree one class I was required to take was History of Psychology. In addition to "therapies" like lobotomy, leukotomy, lobectomy, and really bad ideas like the eugenics movement, one of the controversial subjects covered in the class was electroconvulsive therapy. I admit that I was surprised to learn that it was still used, and shocked to learn it was considered quite beneficial for a very short list of disorders and was never--never--brutal and inhumane and harmful as depicted in that movie.

I'd say that, as is, the Wikipedia page for this subject is thorough and useful and has most bases covered. However there's one vital fact that seems to be missing from the page, and that's the reason convulsive therapy originally emerged as a treatment for mental disorders. It's something I learned in that History class named above. And the only reason I'm not editing the page and adding it myself is because I simply don't have a citation to anchor it with. And having worked for some years as a paralegal I'm loath to state something as fact without a cite to authority to back it up.

The reason convulsive therapy arose as a treatment was because of a simple observation. Back in the bad old days where anyone seeming a bit off, or suffering from then-unexplainable disorders (e.g. epilepsy), could be and often was locked up in a sanitarium, essentially a jail in everything but name. There were, though, people working in some of them who were interested in the science of what the hell was wrong with these people. Having no real theories or the experimental background to do anything else, these people started with observation and documentation. The early modern science of the study of the mind and mental health started with that. Watching what happened and writing it down. After much observation, one idiosyncratic fact emerged, that was consistent among patients, observers, and institutions--and this is the fact the page needs to state explicitly.

People who suffered from severe "melancholy"(depression) who also had seizures or "fits" (epilepsy) often experienced a marked remission in their depression following a seizure.

Nobody knew why, though idiots like Freud often put forward cockamamie theories with no basis in science or fact to explain the phenomenon. And some didn't bother to care why. It was only a short logical jump from observing the phenomenon to experimenting with it by inducing seizures in people with depression who did not also suffer a convulsive disorder. And though early means of inducing these seizures was with various substances, none really safe, the phenomenon held and suddenly became a hypothesis. Inducing seizures in patients with certain mental disorders was frequently followed by a lessening or remission of the symptoms of those disorders. The most important one of course being depression which up to that point had never been effectively treated before, unless it was with the "talking cure" which worked for some with mild symptoms, or with opium or (later) one of its derivatives (like morphine or heroin). The opiates worked for many, of course, though they might not have realized the wonder-medicine they had been given was little more than a tincture of opium. After the Harrison act that line of treatment was choked off and de-legitimized in the US, and most of the so-called civilized world followed suit to one degree or another. Given the utter lack of any other effective pharmaceutical treatment options that left convulsive therapy and "the talking cure" (a form of which is Psychoanalysis, though you'd never get the few fossils in the field still perpetrating that fraud to admit it) as the only effective legal means of treating depression. And only one of the two was effective on severe, intractable depression (and sorry to all you Sigmund Fraudians out there it wasn't the talking cure) and given therapists desperate to treat suffering patients with something that had been shown to actually work, it's easy to see why convulsive therapy became so widely used.

If I can dig up my old textbook from that class, or if I run across any other supporting citations, I'll edit the page to add the fact. Unlikely though, as I don't work in the mental health field and don't spend much time reading its material any more. Too busy playing Battlefield, I guess.

And the rest, as they say, is Wiki. And can be found on the main page. 2602:306:333A:8650:106D:DAB1:1DF1:5545 (talk) 05:36, 27 September 2017 (UTC)

I agree with much of what you've said here, and will say that there is still quite a bit left to be improved in regards to the article. I'm an English education major, and I wrote a fairly detailed essay on ECT back in the day - not entirely uninspired by my own interpretation of "One Flew Over the Cuckoo's Nest." My psychology professor did not care for it... in any case, this is probably part of the reason why I am an English major, rather than a psychologist today. I think the "vital fact" that you mention remains unclear. Frankly, I think it is a common misconception today that the ECT procedure is something like the lobotomy: a medical practice that we associate with the distant past, that has been somehow been mediated and is quite rare now. Yet according to the resources available, it is still quite commonplace - not so nearly as horribly conceived as it was back then, but then - who knows? This article could certainly benefit from experts in the field who might illustrate to us under what circumstances this practice still occurs, and why, and under what voltage. <> Alt lys er svunnet hen (talk) 09:04, 3 November 2017 (UTC)