Medics row over use of ‘brutal' brain therapy

Memory loss can be side effect but supporters say it is a valuable last option

Monday, 20th June

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A ROW has erupted about electric shock therapy which is being used to treat some of Camden’s most vulnerable mental health patients.

Prof John Read, a professor of clinical psychology at the University of East London, said electroconvulsive therapy (ECT) was outdated, and claimed its continued use in Highgate Mental Health Centre was part of a “national medical scandal”.

The treatment involves electrical currents being sent through the brains of patients who are placed under a general anaesthetic, at times against their will.

It induces convulsions that are believed to flood the brain with serotonin and reverse effects of acute depression, although the Royal College of Psychiatrists accept there can be significant side effects including memory loss.

Prof Read told the New Journal: “There is no proper monitoring or regulation of ECT, which is a national medical scandal. There is no robust evidence that it works and it is targeted at women, particularly older women.”

He said a “small and dwindling number of psychiatrists genuinely believe it helps depressed people”, adding: “It is only ever supposed to be used as a last resort. Brains are damaged. Memory is lost. They are putting through 150 volts of electricity through the brain. Does it sound like a good idea to you?”

But the consultant who runs the service in Highgate has this week defended the practice in a war of words with his critics who he dismissed as “alarmist” and “stigmatising disinformation”.

Professor Robert Howard said in an online post this week: “ECT is reserved for the most unwell, whose suffering and risk of deterioration cause of profound anxiety to their families and care teams.

“Choosing to have treatment for yourself or a loved one isn’t easy and these decisions don’t need to be made harder by reckless disinformation.”
ECT is often used on patients who are in danger of dying through refusing to eat or take medication.

Professor Howard said last month, in a tweet, that his critics had “never had a response when you ask them how they would manage a person with psychotic depression who was refusing all food and fluids, had already received other drug and non-drug treatments and was at serious risk of death without ECT.
“They never take this responsibility.”

Figures show that in the 1970s ECT was being used on around 50,000 people a year. That figure has now dropped to around 2,000. In Camden, 85 per cent of ECT patients are women.

The Royal College of Psychiatrists says that up to 40 per cent of patients will have temporary side effects and 7 per cent “persistent memory loss”.

But they say its use can reduce risk of suicide and help those refusing food or drug treatment comply.

It accredited the Highgate ECT service in March – for the first time – in what Camden and Islington Foundation Trust said was recognition of an “excellent service that this team has been providing for many years.”

A C&I statement said: “ECT is a well-recognised, safe, NICE-approved treatment that is often a life-saving intervention for a small number of people for whom other options have been exhausted.

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