Ethical Implications of Electroconvulsive Therapy: A Review

González-Pando, David; Menéndez, Ana Gónzalez; Aparicio-Basauri, Víctor; Garza, César Luis Sanz de la; Torracchi-Carrasco, Esteban; Pérez‐Álvarez, Marino

doi:10.1891/ehpp-d-21-00002

Cited by 4 publications

(2 citation statements)

References 50 publications

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“…A subsequent discussion regarding the ethics of ECT concluded: Although most of the medical literature states that ECT is an effective and safe technique, there is no conclusive evidence of long-term effectiveness (González-Pando et al, 2021). …”

Section: Electroconvulsive Therapymentioning

confidence: 99%

Depression: why drugs and electricity are not the answer

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2022

Psychol. Med.

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The dominant view within mental health services and research suggests that feeling depressed is a kind of medical illness, partially caused by various biological deficits which are somehow corrected by physical interventions. This article critically appraises evidence for the effectiveness and value of antidepressant drugs and electroconvulsive therapy (ECT), the two principle physical treatments recommended for depression. It also describes the negative effects of these interventions and raises concerns about how they impact the brain. We propose an alternative understanding that recognises depression as an emotional and meaningful response to unwanted life events and circumstances. This perspective demands that we address the social conditions that make depression likely and suggests that a combination of politics and common sense needs to guide us in providing help for one another when we are suffering in this way. This alternative view is increasingly endorsed around the world, including by the United Nations, the World Health Organization and service users who have suffered negative consequences of physical treatments that modify brain functions in ways that are not well-understood.

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Section: Electroconvulsive Therapymentioning

confidence: 99%

Depression: why drugs and electricity are not the answer

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2022

Psychol. Med.

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“…In such cases, neurostimulation techniques, especially electroconvulsive therapy (ECT), show a considerable success rate [21]. However, ECT carries the additional risk of anesthesia, its availability is still limited in many countries, and despite firm evidence for its effectiveness, it is not universally accepted by the public [21][22][23][24]. Given the high individual suffering and societal burden, there is a strong rationale for identifying novel preventive measures and treatment approaches to treat depression.…”

Section: Introductionmentioning

confidence: 99%

Exploring the Therapeutic Potential of Gamma-Aminobutyric Acid in Stress and Depressive Disorders through the Gut–Brain Axis

Liwinski,

Lang,

Brühl

et al. 2023

Biomedicines

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Research conducted on individuals with depression reveals that major depressive disorders (MDDs) coincide with diminished levels of the inhibitory neurotransmitter γ-aminobutyric acid (GABA) in the brain, as well as modifications in the subunit composition of the primary receptors (GABAA receptors) responsible for mediating GABAergic inhibition. Furthermore, there is substantial evidence supporting the significant role of GABA in regulating stress within the brain, which is a pivotal vulnerability factor in mood disorders. GABA is readily available and approved as a food supplement in many countries. Although there is substantial evidence indicating that orally ingested GABA may affect GABA receptors in peripheral tissues, there is comparatively less evidence supporting its direct action within the brain. Emerging evidence highlights that oral GABA intake may exert beneficial effects on the brain and psyche through the gut–brain axis. While GABA enjoys wide consumer acceptance in Eastern Asian markets, with many consumers reporting favorable effects on stress regulation, mood, and sleep, rigorous independent research is still largely lacking. Basic research, coupled with initial clinical findings, makes GABA an intriguing neuro-nutritional compound deserving of clinical studies in individuals with depression and other psychological problems.

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Long-Term Adverse Effects After Electroconvulsive Therapy (ECT): A Narrative Analysis Exploring People’s Experiences, Meaning-Making, and Coping

Shipwright,

Murphy

2024

Qual Health Res

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Approximately 2500 people receive electroconvulsive therapy (ECT) annually in the United Kingdom; however, there is growing evidence of long-term adverse effects. Few studies have focused on people’s experience of ECT, particularly over the long term. The experience of ECT is known to be complex, requiring qualitative exploration. Therefore, this study aimed to explore the long-term adverse experiences of ECT, including psychological impacts, meaning-making, and coping. Narrative analysis considered thematic, structural, and performative elements of seven people’s stories. Themes were explored across the timeline of participants’ experiences. Before ECT, participants felt misinformed regarding ECT and misunderstood by healthcare professionals. They noticed immediate changes in their cognition, memory, and mood after ECT. Returning home was important in participants’ discovery of differences. Long-term impacts were loss (of ability, memory, humanity, and connection), the realization that ECT had been damaging, and understanding ECT to have caused brain damage. The extensive nature of loss experienced by participants was comparable to the concept of ambiguous loss. They experienced a lack of follow-up care and denial of their experiences, which could contribute to psychological iatrogenic harm. Participants coped with adverse experiences by using prompts and strategies and connecting with others. Further research is needed into the adverse long-term effects of ECT, especially considering cognitive effects, memory loss, and how these contribute to a changed sense of self. Service development is urgently required, especially for ECT follow-up care.

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Ethical Implications of Electroconvulsive Therapy: A Review

Cited by 4 publications

References 50 publications

Depression: why drugs and electricity are not the answer

Depression: why drugs and electricity are not the answer

Exploring the Therapeutic Potential of Gamma-Aminobutyric Acid in Stress and Depressive Disorders through the Gut–Brain Axis

Long-Term Adverse Effects After Electroconvulsive Therapy (ECT): A Narrative Analysis Exploring People’s Experiences, Meaning-Making, and Coping

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