Meta-study of ECT concludes 'its use cannot be scientifically justified'
A comprehensive review of electroshock therapy (ECT) has concluded that the risk of damage caused by the procedure cannot justify its continued use in medicine.
The review of more than 100 previous studies and reports into ECT was carried out by two psychologists, Dr John Read of the University of Auckland and Professor Richard Bentall of the University of Bangor in Wales. Both are noted critics of electro shock treatment and the medical model used in psychiatry.
The findings, published in the December issue of the international scientific journal Epidemiologia e Psichiatria Sociale, state there is minimal support for the effectiveness of ECT in the treatment of depression or schizophrenia. In addition, it states there is no evidence of any benefits beyond the treatment period.
It concludes: “Given the strong evidence of persistent and, for some, permanent brain dysfunction ... and the evidence of a slight but significant increased risk of death, the cost-benefit analysis for ECT is so poor that its use cannot be scientifically justified.”
In a statement, Dr Read said the findings suggest that ongoing campaigns by ECT recipients to have the treatment banned were supported by the lack of scientific evidence that it was either safe or effective.
“If we took an evidence-based approach to the heated controversy about ECT it would be banished to the historical rubbish bin of previous treatments thought to be effective in the past, such as rotating chairs, surprise baths and lobotomies,” he said.
Prof Bentall added that the short-term benefits gained by a small minority could not justify the risks to which patients were exposed.
“The continued use of ECT therefore represents a failure to introduce the ideals of evidence-based medicine into psychiatry. This failure has occurred not only in the design and execution of research, but also in the translation of research findings into clinical practice. It seems there is resistance to the research data in the ECT community, and perhaps in psychiatry in general,” he said.
The continued use of forced ECT is a source of ongoing controversy in Ireland. Latest figures show that about 400 psychiatric patients received ECT treatment during 2008. Of this number, at least 43 were involuntarily detained patients, either unable or unwilling to consent.
Under current mental health laws, ECT can be used where a patient is “unable or unwilling” to give consent once it has been approved by two consultant psychiatrists.
Mental health campaigners, including the Wellbeing Foundation, say this section of the law should be deleted to protect patients.
Download Read and Bentall's paper here
Moloney rejects anti-ECT Bill but promises debate and consultation
The Bill to outlaw the forced administration of Electro-shock 'therapy', introduced into the Senate in June 2008, was debated again on Wednesday 2 December 2009.
Unfortunately, Mental Health Minister John Moloney did not accept the Bill put forward by senators Deirdre de Burca, Dan Boyle and David Norris, but he did make some promises and set down a timetable for further discussion with action to follow.
De Burca and Boyle proposed to limit the thrust of their original Bill to a provision which would have removed Section 59 (b) of the Mental Health Act 2001, which permits forced administration of ECT once two consultant psychiatrists have approved the forced administration.
Senators, notably Dan Boyle himself, made some interesting contributions to the debate, which you can read in full here or download here. Boyle cautioned in particular against the false standard of legislating for the extreme case — in this instance, the extremely rare risk of an individual risking death if not given ECT — so that a large number of persons at no such risk are then wrongly given the 'extreme' treatment.
Minister Moloney asked the proposers to postpone debate on their Bill to allow further consultation, and he gave a commitment to conclude that consultation by March 2010. He proposes to have advocates of forced ECT and opponents give evidence to him setting out their points of view, during the first quarter of 2010. That consulation period is now over. We eagerly await the Minister's proposals.
Download Read and Bentall's paper here
The shocking evidence on electroshock: no therapy
Electro-Convulsive Therapy is no therapy at all. That is the clear conclusion from research carried out by leading figures in the field and which the Wellbeing Foundation republishes here as a public service in the continuing debate on ECT (see below for links to download these papers).
Anti-ECT campaigners, whether lay people or qualified doctors, have been vilified by certain supporters of ECT in the psychiatric profession and accused of producing no evidence to support their claims that ECT is both damaging and ineffective. Here, then, is that evidence, and it is safe to say that this evidence comes from professionals far more eminent in their field than any of our critics here in Ireland.
Most of this evidence has been available to professionals and the curious public for over a year. For example, the first scientific paper we reproduce, 'The Cognitive Effects of Electroconvulsive Therapy in Community Settings', was published in the journal Neuropsychopharmacology in 2007. One dates from 1998, the others from 2005, 2006 and again 2007. One might be tempted to think, from the subsequent contributions by certain Irish psychiatrists, that the latter are ignorant of this important research or have not read and evaluated it.
One of the notable things about the the first paper mentioned is that its lead author, Harold J Sackeim, is a prominent advocate of the medical model and of the school of biological psychiatry, a school whose very basis we question. Dr Sackeim has for many years been a leading advocate of ECT. Yet in this paper he comes as close as one could expect to a public recantation of his previous views. Dr Sackeim, to his credit, has led a team which collected evidence, solid, empirical evidence, of the cognitive impairments (read, memory loss and intellectual impairment) caused by ECT even in its 'least worst' form.
And Dr Sackeim has taken account of that evidence — he now rejects, at the very least, the widespread use of ECT, and more particularly the use of most forms of ECT (certainly those widely used here in Ireland).
This gamekeeper has turned poacher. Would that his Irish colleagues take note, and even follow suit.
The other papers are as valuable, and all give evidence supporting and bolstering our view that ECT is medically dangerous and should be banned. The earliest is Dr Peter Breggin's famous study from 1998, 'Electroshock: scientific, ethical, and political issues', published in the International Journal of Risk & Safety in Medicine .
'Patients' perspectives on electroconvulsive therapy: a systematic review' was published in the British Medical Journal in January 2005; 'Memory and cognitive effects of ECT: informing and assessing patients' in Advances in Psychiatric Treatment in 2006; 'Cognitive rehabilitation: assessment and treatment of persistent memory impairments following ECT' in the same journal in 2007; and we include, for its inherent interest and for providing some profound insights by those on the sharp end, 'The Electroshock Quotationary' by Leonard Roy Frank, published in June 2006.
Over 1,100 hear Robert Whitaker dissect mental health epidemic
Acclaimed US medical journalist Robert Whitaker spent a week in Ireland on a speaking tour. His latest book, Anatomy of an Epidemic, investigates the astonishing rise of mental illness in the developed world.
Anatomy of an Epidemic has won Robert the top award for a book in the 2010 Investigative Reporters and Editors Awards.
More than 1,100 people in all attended Robert's lectures while he was here, in Athlone, Cork and Dublin, and he was interviewed on Today With Pat Kenny, by Carl O'Brien in the Irish Times and Jennifer Hough in the Irish Examiner, as well as by several other media outlets througout the country. We have a podcast of Robert's Today with PK appearance here.
The big question Robert's new book asks is this: Why has the number of adults and children disabled by mental illness skyrocketed over the past 50 years? Why does this epidemic so closely parallel the growth and dominance of psychiatric drugs as treatment?
Robert's book has the answers to these questions and more. While it has not yet been published on this side of the Atlantic, the Wellbeing Foundation has copies available at a reduced price from our sales partner, The Crow's Feather. Just click the link in the ad above.
Corry slams ECT
In a hard-hitting article in the Irish Medical Times, Dr Michael Corry analyses the cover-up of ECT by both the Mental Health Commission and the Inspector of Mental Health Services.
Read it here
A neuroscientist's view
Eminent neuroscientist Professor Peter Sterling is not the only brain expert to oppose the use of ECT; many neurosurgeons, neuroscientists, and neuro-biologists have condemned ECT as dangerous and irrational. But Sterling manages to sum up the case in four brief pages, well supported with references to other practitioners.
ECT (Electro Convulsive Therapy) received a big boost
on 25 June 2008 when a Private Members Bill was debated for two hours
in Seanad Eireann.
The other is Section 59, dealing with ECT. The Bill would ban the use of ECT without the consent of the patient concerned.
At present, electric shock
treatment is widely used on involuntary patients in mental hospitals in
The debate was adjourned without a vote, so the Bill lives to be debated further following the investigations proposed by several senators and accepted by the proposers.
A number of anti-ECT campaigners from around the country attended the debate, joined in a welcome act of solidarity by Professor Ivor Browne, retired Professor of Psychiatry at UCD and formerly Chief Psychiatrist of the Dublin and Eastern health region. The group included John McCarthy of Mad Pride Ireland who contested the last general election as an independent candidate representing mental health service users, Drs Michael Corry and Aine Tubridy, and authors Mary and Jim Maddock of MindFreedom Ireland.
The Final Solution:
Electro Convulsive Therapy (ECT) is the deliberate administration of electric shocks to the brain. This is how it was described by the British Department of Health in 2007: "ECT is carried out under general anaesthetic, and a strong muscle relaxant is administered to patients to prevent the violent muscle spasms that the treatment would otherwise cause. The patient is strapped on their back to a flat table which, in the event of a patient vomiting, can be spun upside down.
ECT being administered
"In the presence of an anaesthetist and psychiatrist, electrodes are attached to the patients' head and the electrical voltage is administered until the psychiatrist observes the patients' toe twitch. This is a sign that the patient, despite the relaxant drugs, is convulsing. Up to 400 volts are used."
It is better described as a Holocaust of the brain: a brutal Final Solution which must be stopped. The time to abolish electric shock treatment is now.
Senate vote on ECT leaves power to electro-shock in hands of docs
Senator Dan Boyle was forced into a compromise on his Bill to delete Section 59.b of the Mental Health Act 2011 in the Senate on 24 March 2011.
The Boyle/Norris/De Burca Bill on ECT was simple: delete Section 59.b and replace with an ECT clause requiring consent in all cases. Senators Ivana Bacik and Phil Prendergast (Labour Party) gutted this by proposing an alternative Government-driven amendment to keep Section 59.b and merely delete the words "or unwilling" from it.
This leaves ultimate power in the hands of the consultant psychiatrist, as the amended section still allows an electric shock to the brain to be given "where the patient is unable to give such consent".
As the judgment on whether a patient is capable of giving or refusing consent lies in the hands of the psychiatrist, the psychiatrist need only interpret 'unwillingness' as 'inability' and shock away.
Read the Senate debate here
Facebook discussions here
Launch of critical psychiatry movement ends successful conference
The Dr Michael Corry memorial conference on 10 and 11 November 2010 in Cork was a resounding success. Over 300 delegates registered for the two-day event and some had to be turned away.
The conference was dedicated to the life and work of Dr Michael Corry, who was a keynote speaker at the previous year’s conference.
For our first short reports of the conference and to view photos, go to our Facebook page here
Seroxat to blame for baby's heart defects, says US jury
14 October 2009 (The Guardian) — A family has been awarded $2.5m (€1.7m) in damages after a jury in Philadelphia decided that the British-made antidepressant Seroxat was responsible for their three-year-old son's heart defects.
GlaxoSmithKline, the British manufacturer of Seroxat, known as Paxil in the US, said it would appeal against the verdict. Although drug regulators in the US and UK warned in 2005 that Seroxat could be linked to heart defects, GSK does not accept its drug is the cause.
Drug regulators warned in 2005 that Seroxat could be linked
to heart defects
Thousands of women worldwide have taken antidepressants such as Seroxat in pregnancy, assured by manufacturers and doctors that they are safe. The case is one of a number in the US and the first to end in a verdict against the company.
Michelle David, 24, was prescribed Paxil in the US after panic attacks. Around mid-February 2005, she discovered she was pregnant. According to her lawyer, Sean Tracey of Houston, Texas, her obstetrician gave her the standard advice at the time: that Paxil was safe. David later stopped taking it because of side-effects that might have been attributable to the pregnancy.
Her son, Lyam Kilker, was born in October 2005. A couple of weeks later he stopped feeding and doctors found he had two holes in the heart and a very rare congenital defect called an interrupted aortic arch. "The hospital put in a stent to keep him alive," said Tracey. "He had acquired an infection — the heart condition made him more susceptible."
Soon afterwards, Lyam had the first of two open heart operations and spent five months in hospital. He will need more major heart surgery in five to 10 years.
A number of studies have suggested that rates of congenital heart defects are higher among women taking Paxil and other drugs of the SSRI (selective serotonin reuptake inhibitor) class. David Healy, professor of psychiatry in Bangor, Wales, who gave evidence in the Kilker case, said that at 4%, the rate of birth defects was double the normal rate, while the rate of major defects was 2% compared with 1%. The general rate of miscarriages is 8%, but 16% of women on Seroxat miscarry.
GSK denied that its drug was responsible for harm to babies in the womb. "While we sympathise with Lyam Kilker and his family, the scientific evidence does not establish that exposure to Paxil during pregnancy caused his condition," said the company in a statement. "Very unfortunately, birth defects occur in 3-5% of all live births, whether or not the mother was taking medication during pregnancy.
"GlaxoSmithKline acted properly and responsibly in conducting its clinical trial programme for Paxil, including sharing documentation and submitting results from studies on Paxil to regulators. Once approved for use, the company acted properly in marketing the medicine, including monitoring its safety, updating pregnancy information in the medicine's labelling as new information became available, and in communicating important safety information to regulatory agencies, the scientific community and the public."
Lawyers for women in the US allege that GSK knew of the problem earlier than it admits. Internal documents produced at the Kilker trial suggest that it was investigating complaints as early as 2001, when a woman emailed GSK to ask whether Paxil could be the reason for her baby developing severe heart defects in the womb. The pregnancy was terminated.
GSK replied with a formal letter telling her to consult her doctor. But an internal report recorded that the link between her baby's defects and Paxil was "almost certain". In court, GSK officials said the report was a mistake and that somebody had filled in the form wrongly.
— by Sarah Bosely
© The Guardian 2009
Corry complaint psych boss has cash links to five drug makers
The senior psychiatrist Professor Ted Dinan of University College, Cork, who laid a complaint against Dr Michael Corry at the Medical Council, has been paid or had his work financed by at least five different drug companies.
In a letter to the Council's Fitness to Practice Committee, Dinan said Dr Corry had made comments about a tragedy "without regard for the distress" caused to the families; had "made allegations regarding the competence" of a colleague"; "made statements regarding a diagnosis without ever seeing the patient"; and made "statements regarding the pharmacology of antidepressants".
Dinan is an enthusiastic advocate of SSRIs and SNRIs and has declared his close relations with several drug companies as follows: "Dr Dinan has received honoraria [cash payments] from and is a member of the speakers board and advisory board for Lilly, Pfizer, Lundbeck, and Organon." His Cork Neuroscience Group is funded by, among others, GlaxoSmithKline, maker of Seroxat, and the Wellcome Trust (an offspring of GSK's parent companies which funds biomedical research).
The professor has made previous attempts to chill debate on the mental health services and on the dangers, efficacy or otherwise of the treatments his profession holds dear, in particular the use of SSRIs and SNRIs to treat depression and other complaints.
The professor has close relations with several of the makers of the drugs he espouses and defends, and whose critics he is trying to silence. A statement of disclosure related to a course he has taught says: "Dr Dinan has received honoraria [cash payments] from and is a member of the speakers board and advisory board for Lilly, Pfizer, Lundbeck, and Organon." (Reference here)
The professor's Cork Neuroscience Group is funded by, among others, the Wellcome Trust (which funds biomedical research) and GlaxoSmithKline, which itself resulted from two mergers. The first merger saw Burroughs Wellcome, founder of the Wellcome Trust, join with Glaxo plc, to form GlaxoWellcome. This later fused with SmithKline Beecham to create GSK, second largest drug company in the world and manufacturer of Seroxat/Paxil.
He speaks at meetings which advocate the view that depression is underdiagnosed in Ireland by as much as 75% and that SSRIs are an essential treatment. For an example, see here
Signing himself as Timothy Dinan, MD, PhD, FRCPsych, FRCPI, Professor of Psychiatry, University College Cork, the academic was one of six professors of psychiatry who penned a letter published in the Irish Times on 16 November 2006 demanding the resignation of the then Minister for Mental Health, Tim O'Malley, for two reasons.
One, O'Malley had dared to suggest that many everyday difficulties of life were being mis-labeled as 'clinical depression'. Secondly, he had dared to suggest, with good reason, that the alleged benefits of medications used to treat mental illness cannot be proven scientifically in the way that other medications can. Both suggestions are cardinal sins for those who rule the world of psychiatry, and whose word is law among the students they teach.
Interestingly, the 'six professors letter' drew a ferocious wave of disagreement, from former patients, from psychiatrists and GPs, from nurses, and from senior sociologists who have been studying the the use of psychiatric medications and such 'therapies' as electro-shock for many years.
Among the 'senior psychiatrists' who disagreed with the six ruling professors was a former professor, perhaps the most distinguished professor of psychiatry this country has produced, Professor Emeritus Dr Ivor Browne.
Clearly, the response to that intervention has not blunted the desire of at least one of their number to chill debate and silence critics of institutional psychiatry and bad medicine.
In this latest attempt, the most chilling part of the complaint is that Corry made "statements regarding the pharmacology of antidepressants". If such a complaint was upheld as valid, neither Dr Corry nor any other doctor registered with the Irish Medical Council could ever again 'make a statement' on the action of a drug such as Seroxat or Lexapro — or, by extension, of any drug.