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Post by Admin on Apr 7, 2019 11:17:50 GMT
Should we stop using electroconvulsive therapy? BMJ 2019; 364 doi: doi.org/10.1136/bmj.k5233 (Published 30 January 2019) Cite this as: BMJ 2019;364:k5233 www.bmj.com/content/364/bmj.k5233Electroconvulsive therapy has no long term benefits compared with placebo and often causes brain damage, say John Read and Sue Cunliffe. But Sameer Jauhar and Declan M McLoughlin argue that evidence shows ECT is effective and safe in depression and that adverse side effects can be managed Yes—John Read and Sue Cunliffe Electroconvulsive therapy (ECT) was first administered in 1938. The first study, in 1951, showed that people who had had ECT fared worse than those who hadn’t.1 Today, positive, evidence based, risk-benefit analyses are required for treatments. However, systematic23 and narrative4 reviews (by JR and colleagues) identify only 10 studies comparing ECT with placebo for depression (placebo includes general anaesthetic but no shock). Half found no difference. The other five found a temporary lift in mood, but only during the treatment period, and in about only a third of patients. In the famous Northwick Park study5 this minimal improvement was perceived only by psychiatrists, not by nurses or patients. The many reviews and meta-analyses claiming that ECT works67 do so purely on the basis of these temporary gains, in a minority of patients, found in just half the studies. Furthermore, none of them identify any placebo controlled studies showing that ECT reduces depression beyond treatment or prevents suicide.234 Despite this lack of evidence psychiatry remains so adamant ECT works that no studies to establish efficacy have been conducted since 1985.234 Instead, many studies investigate which kind of ECT causes least damage.2 Memory loss and brain damage Brain cells receive electrical signals of a fraction of one volt. Subjecting them to 150 V inevitably causes damage, similar to traumatic brain injury.8 Early post-mortem examinations led to the article “Brain damaging therapeutics,” in which the …
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Post by Admin on Apr 13, 2019 11:03:21 GMT
A scientific understanding of electricity’s effects on the human body has only been around since the last half of the 20th century. If this understanding of electric shock and electrical injury was had in the first part of the 20th century, electroconvulsive therapy (ECT) would likely never have been accepted by modern western medicine. ECT Explained by a CET (Certified Engineering Technologist) www.madinamerica.com/2019/04/ect-explained-engineering-technologist/
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Post by Admin on Apr 15, 2019 15:51:21 GMT
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Post by snowstorm on Apr 15, 2019 21:01:20 GMT
Do find this horrific. All that can be said is that at least the plaintiffs got a well deserved payout. Just what about future 'patients'.
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Post by Admin on Aug 31, 2019 1:23:09 GMT
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Post by Admin on Oct 29, 2019 20:57:05 GMT
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Post by Admin on Jun 3, 2020 11:20:51 GMT
ECT depression therapy should be suspended, study suggests By Mark Easton Home editor www.bbc.co.uk/news/uk-52900074The use of electroconvulsive therapy (ECT) to treat people with depression should be immediately suspended, according to a new study. ECT involves passing electric currents through a patient's brain to cause seizures or fits. The study's lead author says there was "no place" for ECT in evidence-based medicine due to risks of brain damage. At least 1,600 patients were given ECT in the UK and Ireland in 2017, according to psychiatrists. The National Institute for Health and Care Excellence (NICE) currently recommends the use of ECT for some cases of moderate or severe depression as well as catatonia and mania.
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Post by Admin on Jun 3, 2020 17:48:33 GMT
A new review, published in Ethical Human Psychology and Psychiatry, re-assesses studies that compare electroconvulsive therapy (ECT) with placebo treatment for depression. The analysis also assesses the only five available meta-analyses that claim that ECT is effective. The authors of the review point to the lack of quality research available to support the use of ECT, and call for the use of ECT to be suspended immediately until this research is done. John Read, the lead author, and Professor of Clinical Psychology at the University of East London, explains: “In conjunction with the high risk of brain damage from ECT, this absence of efficacy evidence means that the cost-benefit ratio is so appalling that there is no place for ECT in evidence-based medicine.” www.madinamerica.com/2020/06/new-review-finds-lack-evidence-support-ect/
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Post by Admin on Jun 3, 2020 19:20:35 GMT
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Post by Admin on Jun 5, 2020 16:44:27 GMT
Guest blog by Richard P. Bentall: ECT is a classic failure of evidence-based medicine by Admin on 04/06/2020 in Experts A commentary on Read, J., Kirsch, I., & McGrath, L. (2020). Electroconvulsive therapy for depression: A review of the quality of ECT versus sham ECT trials and meta-analyses. Ethical Human Psychology and Psychiatry, 21, 64-103. Richard P. Bentall, Professor of Clinical Psychology, University of Sheffield cepuk.org/2020/06/04/guest-blog-by-richard-bentall-ect-is-a-classic-failure-of-evidence-based-medicine/
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Post by Admin on Jun 5, 2020 21:47:00 GMT
Research Article Electroconvulsive Therapy for Depression: A Review of the Quality of ECT versus Sham ECT Trials and Meta-Analyses Read, John, PhD Kirsch, Irving, PhD McGrath, Laura, PhD Ethical Human Psychology and Psychiatry Vol 21 Issue 2 , DOI: 10.1891/EHPP-D-19-00014 connect.springerpub.com/content/sgrehpp/21/2/64Abstract Background Electroconvulsive therapy (ECT) is still being administered to approximately a million people annually. There have been no ECT versus simulated ECT (SECT) studies since 1985. The five meta-analyses of ECT versus SECT studies all claim that ECT is more effective than SECT for its primary target, severe depression. This review assesses the quality of those meta-analyses and of the 11 studies on which they are based. Methods The meta-analyses were evaluated primarily in terms of whether they considered the quality of the studies they included, but also in terms of whether they addressed efficacy beyond end of treatment. The methodological rigor of the 11 studies included by one or more of the meta-analyses was assessed using a 24-point Quality scale developed for this review. Results The five meta-analyses include between 1 and 7 of the 11 studies. The meta-analyses pay little or no attention to the multiple limitations of the studies they include. The 11 studies have a mean Quality score of 12.3 out of 24. Eight scored 13 or less. Only four studies describe their processes of randomization and testing the blinding. None convincingly demonstrate that they are double-blind. Five selectively report their findings. Only four report any ratings by patients. None assess Quality of Life. The studies are small, involving an average of 37 people. Four of the 11 found ECT significantly superior to SECT at the end of treatment, five found no significant difference and two found mixed results (including one where the psychiatrists reported a difference but patients did not). Only two higher Quality studies report follow-up data, one produced a near-zero effect size (.065) in the direction of ECT, and the other a small effect size (.299) in favor of SECT. Conclusions The quality of most SECT–ECT studies is so poor that the meta-analyses were wrong to conclude anything about efficacy, either during or beyond the treatment period. There is no evidence that ECT is effective for its target demographic—older women, or its target diagnostic group—severely depressed people, or for suicidal people, people who have unsuccessfully tried other treatments first, involuntary patients, or children and adolescents. Given the high risk of permanent memory loss and the small mortality risk, this longstanding failure to determine whether or not ECT works means that its use should be immediately suspended until a series of well designed, randomized, placebo-controlled studies have investigated whether there really are any significant benefits against which the proven significant risks can be weighed. Electroconvulsive therapy (ECT) is still used on approximately a million people annually (Leiknes, Jarosh-von Schweder, & Hoie, 2012; Read, Bentall, Johnstone, Fosse, & Bracken, 2013). A review of 70 studies found, however, “large variation between continent, countries and regions in utilization, rates and clinical practice” (Leiknes et al., 2012, p. 296). For instance, a recent audit found a 12-fold difference in usage between the highest and lowest using regions of England (Read, Harrop, Geekie, & Renton, 2018). The many recent studies that either compare ECT to other treatments, or compare different types of ECT with each other (Read & Arnold, 2017), typically open with an unqualified statement that ECT is a very effective treatment for depression. Some may consider these types of studies sufficient to justify the use of ECT. We contend, however, that, ECT must be assessed using the same standards applied to psychiatric medications and other medical interventions, with placebo-controlled studies as the primary method for assessment. There have, however, only ever been 11 placebo-controlled studies of the efficacy of ECT. The last study comparing ECT with sham/simulated ECT (SECT), in which the general anaesthetic is administered but the electricity is not, was 35 years ago (Gregory, Shawcross, & Gill, 1985). This review evaluates, for the first time, the impartiality and robustness of the meta-analyses of this small body of literature, and the quality of the studies cited in the meta-analyses. The primary goal is not to assess whether or not ECT is effective. The intent, instead, is to determine whether the available evidence is robust enough to answer that question.
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Post by Admin on Jun 8, 2020 19:28:18 GMT
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Post by Admin on Jun 13, 2020 19:37:30 GMT
John Read and Irving Kirsch – Electroconvulsive Therapy (ECT) Does the Evidence From Clinical Trials Justify its Continued Use? www.madinamerica.com/2020/06/john-read-irving-kirsch-electroconvulsive-therapy-ect-evidence-clinical-trials-justify-continued-use/James Moore www.letstalkwithdrawal.comJames Moore has experienced the psychiatric system and psychiatric drugs firsthand following a stress-related breakdown. Believing himself to be fundamentally broken, he spent many years on psychiatric drugs before awakening to the reality that psychiatry has few answers for human difficulties. James produces and hosts the Mad in America podcast, in which he interviews experts and those with lived experience to challenge some common misconceptions about psychiatry, psychiatric drugs and the bio medical model.
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Post by Admin on Jun 17, 2020 17:47:22 GMT
I Lost Direction, Forgot the Way Home – Fighting ECT June 17, 2020 www.madinamerica.com/2020/06/207361/From Israel Hayom: “Regarding the safety issue of the treatment, petitioners claim that the use of the word ‘rare’ to describe the risk of brain damage and loss of memory due to ECT is misleading, since without a standard and universal protocol for supervision and performance, and without routine assessment and monitoring of every patient, there will be never be a real clear indication of the prevalence of brain damage. This is in addition to the fact that, to date, researchers have never followed patients for more than six months from the end of treatment to detect or identify cognitive impairment”. One of the key requirements of this petition is to conduct comprehensive pre-treatment and subsequent testing to detect adverse events ahead of time and prevent a condition of serious or irreversible damages.” 'I lost direction, forgot the way home' Facing the experts and doctors who recommend Electro Convulsive Therapy (ECT) as a solution to serious mental disorders, disturbing evidence of irreversible damage is accumulating. Now the survivors are fighting against it. By Danielle Bronstein Published on 05-31-2020 15:02 Last modified: 06-02-2020 16:25 www.israelhayom.com/2020/05/31/i-lost-direction-forgot-the-way-home/
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Post by Admin on Jul 6, 2020 17:16:52 GMT
Professionals and ECT Recipients Request Suspension of ECT in NHS July 6, 2020 www.madinamerica.com/2020/07/professionals-ect-recipients-request-suspension-ect-nhs/Lead author of the review, and letter, Dr John Read (Professor of Clinical Psychology, University of East London) said: ‘We hope that by the 60th anniversary of Hemingway’s death, this time next year, we will be able to announce to the world that the UK was the first country to finally put an end to this well-intentioned but calamitous error in the history of medicine.’
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