Electroconvulsive therapy – does it work? the Irish Times titles in an interview with Prof Declan McLoughlin, research professor of psychiatry at St Patrick’s University Hospital and Trinity College Dublin, and board member of EFFECT.
“It’s an odd treatment in that it’s actually been around for 80 years, so a lot of people might think ‘God, I can’t believe they’re still doing that’,” says McLoughlin. “The reason we’re still doing it is because it’s still more effective than any other treatment available for depression. It’s “the gold standard”.
In Ireland, about 450,000 people are affected by depression at any one time, according to Aware, an organisation which supports those with depression. Some 6,000 people in severe stages of depression are admitted to Irish psychiatric hospitals every year, accounting for 30 per cent of all admissions.
Worldwide, some 1.4 million people receive ECT every year, with about 250 people having the treatment annually in Ireland. It’s typically deployed for the one-third of patients who develop “treatment-resistant depression”.
“By the time you’re onto your fourth or fifth line of different antidepressant drugs, the chances of responding to another are perhaps in the order of about 10 per cent, while the chances of responding well to the ECT are about 50 per cent,” McLoughlin explains.
Paradoxically, the worse the depression, the better ECT will help. Those who are acutely ill or psychotic “have about an 80-90 per cent chance of recovery with ECT”.
Faster than anti-depressants
ECT works faster than anti-depressants, according to McLoughlin, and patients may see an improvement after about four or five treatments, or two to three weeks. ECT works by promoting the growth of new connections in certain brain regions, including in the hippocampus, which has an important role in mood and memory.
However, its use remains controversial. “The opposition, at one level, is surprising; this is a treatment with a very strong scientific evidence base for its effectiveness – especially in people with serious depression, it can be a life-saving treatment,” says McLoughlin.
Click the image to read the full interview!