From the Editor

Is it safe?

The first treatment of electroconvulsive therapy (ECT) was administered in 1938. Yet decades later, people still debate the safety of this treatment; a study found that one in five patients reported fear of death as a major concern. (And, yes, so many of our patients have seen that movie.)

In our first selection, we consider a new and important paper on this topic, just published in The Lancet Psychiatry. Dr. Tyler S. Kaster (of the University of Toronto) and his co-authors attempt to answer the safety question by comparing those who received ECT with those who didn’t in the context of depression and inpatient care. “In this population-based study of more than 5000 admissions involving electroconvulsive therapy for inpatients with depression, the rate of serious medical events within 30 days was very low among those exposed to electroconvulsive therapy and a closely matched unexposed group (0.5 events per person-year vs 0.33 events per person-year), with those who received electroconvulsive therapy having a numerically lower risk of medical complications.” We look at the big study, with an eye on clinical implications.

ect-1945ECT machine (cira 1950)

In the other selection, we look at a new essay from The New Yorker. Writer Donald Antrim – an accomplished novelist and a MacArthur fellow – discusses his depression, his suicidal thoughts, and his decision to opt for ECT. He notes that after treatment: “I felt something that seemed brand new in my life, a sense of calm, even happiness.”

DG

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