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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by skeptiK on January 4, 2007, at 12:14:17
Well it is about time...Can we really believe anything we are told when it comes to psychiatry? Are these guys true charlatans? Because it sure does feel like it.
The link to the full study is at the end of this PRNewsire.
SkeptiK
Posted by blueberry1 on January 4, 2007, at 14:48:42
In reply to re: ECT is this a surprise?, posted by skeptiK on January 4, 2007, at 12:14:17
ECT is bad. Very very bad.
My pdoc admitted that his success ratio with ECT is 50/50. Not very good. He said it helps some people but rarely brings sustained remission, and that followup treatments have a less than 50/50 chance of working.
The amnesia I had was total 100% for 3 months of my life and none of those memories have come back yet and likely never will. My dad is a retired doctor. He says the amnesia I have experienced is what he usually saw in head trauma cases where people were knocked out for days or weeks in car crashes. He said the pattern is the same...you totally forget the incident, but you also forget the time leading up to it and the time following it, usually encompassing weeks or months.
Ongoing amnesia in small mundane ways occur everyday as I go about my life. Where I put my keys? I forgot to make that phone call? Where did that $20 in my pocket go to? Stuff like that, that never happened before.
I walk around in kind of dizzy fog all the time.
I have never ever in my life considered suing anyone. I constantly have to hold myself back from calling a lawyer. I'm confident I could win something. But the turmoil, time, and stress of it all would weigh me down.
ECT sucks bigtime. I'm glad someone out there who knows what they are talking about is admitting it. Up till now it has just been us mentally ill irrelevent ones.
Posted by SLS on January 4, 2007, at 20:36:07
In reply to re: ECT is this a surprise?, posted by skeptiK on January 4, 2007, at 12:14:17
Neuropsychopharmacology. 2007 Jan;32(1):244-254. Epub 2006 Aug 23.Click here to read Links
The Cognitive Effects of Electroconvulsive Therapy in Community Settings.* Sackeim HA,
* Prudic J,
* Fuller R,
* Keilp J,
* Lavori PW,
* Olfson M.[1] 1Department of Biological Psychiatry, New York State Psychiatric Institute, New York, NY, USA [2] 2Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA [3] 3Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Despite ongoing controversy, there has never been a large-scale, prospective study of the cognitive effects of electroconvulsive therapy (ECT). We conducted a prospective, naturalistic, longitudinal study of clinical and cognitive outcomes in patients with major depression treated at seven facilities in the New York City metropolitan area. Of 751 patients referred for ECT with a provisional diagnosis of a depressive disorder, 347 patients were eligible and participated in at least one post-ECT outcome evaluation. The primary outcome measures, Modified Mini-Mental State exam scores, delayed recall scores from the Buschke Selective Reminding Test, and retrograde amnesia scores from the Columbia University Autobiographical Memory Interview-SF (AMI-SF), were evaluated shortly following the ECT course and 6 months later. A substantial number of secondary cognitive measures were also administered. The seven sites differed significantly in cognitive outcomes both immediately and 6 months following ECT, even when controlling for patient characteristics. Electrical waveform and electrode placement had marked cognitive effects. Sine wave stimulation resulted in pronounced slowing of reaction time, both immediately and 6 months following ECT. Bilateral (BL) ECT resulted in more severe and persisting retrograde amnesia than right unilateral ECT. Advancing age, lower premorbid intellectual function, and female gender were associated with greater cognitive deficits. Thus, adverse cognitive effects were detected 6 months following the acute treatment course. Cognitive outcomes varied across treatment facilities and differences in ECT technique largely accounted for these differences. Sine wave stimulation and BL electrode placement resulted in more severe and persistent deficits.Neuropsychopharmacology (2007) 32, 244-254. doi:10.1038/sj.npp.1301180; published online 23 August 2006.
PMID: 16936712 [PubMed - as supplied by publisher]
Posted by skeptiK on January 4, 2007, at 20:39:01
In reply to re: ECT is this a surprise?, posted by blueberry1 on January 4, 2007, at 14:48:42
So sorry to hear that you are still suffering with that. I guess I am fortunate in that I decided not to do it, but everytime I sink low my p-doc brings it up, and now I feel like, do they really care? Or is it fix the problem at whatever cost?
skeptiK
Posted by Phillipa on January 4, 2007, at 21:41:39
In reply to re: ECT is this a surprise? » blueberry1, posted by skeptiK on January 4, 2007, at 20:39:01
I met a poor girl who had just completed ECT at a group meeting at my pdocs about 9 years ago. She had been a very bright college student had to drop out as she forgot everything. Sad . Love Phillipa
Posted by SLS on January 5, 2007, at 6:46:40
In reply to re: ECT is this a surprise? » blueberry1, posted by skeptiK on January 4, 2007, at 20:39:01
> So sorry to hear that you are still suffering with that. I guess I am fortunate in that I decided not to do it, but everytime I sink low my p-doc brings it up, and now I feel like, do they really care? Or is it fix the problem at whatever cost?
I wouldn't blame your doctor for acting on the information he was taught.
It might be quite awhile before a consensus is arrived at regarding ECT and the pervasiveness and persistence of cognitive side effects.
I went through a series of 15 ECT treatments. I would not do it again. Of course, that it didn't work figures into my decision. The last 9 treatments were bilateral. For me, the cognitive side effects were pronounced and lasted for at least a month. Measurable deficits might have lasted quite a bit longer.
- Scott
Posted by linkadge on January 5, 2007, at 7:35:09
In reply to re: ECT is this a surprise?, posted by SLS on January 4, 2007, at 20:36:07
Yeah, and thats only a 6 month study.
Linkadge
Posted by linkadge on January 5, 2007, at 7:42:23
In reply to re: ECT is this a surprise? » skeptiK, posted by SLS on January 5, 2007, at 6:46:40
>Since the mid-1980s, Sackeim worked as a >consultant to the ECT device
>manufacturer Mecta Corp. He never revealed his >financial interest in ECT to
>NIMH, as required by federal law,There are a lot of changes occuring in this field.
When somebody says that a patient who claims ECT caused dammage is mentally ill and not credable, I think that is a very sick and low way of taking advantage of the sick.
And if it is as this article suggests, this guy was lying about the safety of ECT for $.
Its like "The Emperor's New Cloths", one person lies, and nobody is man enought to tell the truth.
Kubjadge
Posted by skeptiK on January 5, 2007, at 9:23:34
In reply to re: ECT is this a surprise?, posted by linkadge on January 5, 2007, at 7:42:23
> >Since the mid-1980s, Sackeim worked as a >consultant to the ECT device
> >manufacturer Mecta Corp. He never revealed his >financial interest in ECT to
> >NIMH, as required by federal law,
>
> There are a lot of changes occuring in this field.
>
> When somebody says that a patient who claims ECT caused dammage is mentally ill and not credable, I think that is a very sick and low way of taking advantage of the sick.
>
> And if it is as this article suggests, this guy was lying about the safety of ECT for $.
>
> Its like "The Emperor's New Cloths", one person lies, and nobody is man enought to tell the truth.
>
>
> Kubjadge
>
> I know, it seems like this crap just continues to go on and on...I try to educate myself as much as possible regarding all of the possible treatments available. At the end of the day, if there is a way to make money with it they'll come out with some study boasting how efficacious a particular treatment is. Blah, blah, blah...
How about VNS therapy, another scam?
This was part of a recent article I found:"Last week a problem with a favorable review of the Vagus Nerve Stimulation (VNS) device, used to treat depression, was made public. The review was in an influential medical journal, Neuropsychopharmacology , whose editor is Dr. Charles Nemeroff. What was the problem? It’s kind of like that commercial, “I’m not just the Hair Club for Men president – I’m also a client.” Dr. Nemeroff not only is the editor of the journal, he’s one of the authors of the favorable review and – surprise – he has financial ties to the company that makes the VNS device, Cyberonics."
skeptiK
Posted by linkadge on January 5, 2007, at 10:42:41
In reply to re: ECT is this a surprise?, posted by skeptiK on January 5, 2007, at 9:23:34
Its pretty pathetic.
Althought, I would much rather have VNS or DBS, as these two would probably produce a lot less collateral dammage than ECT.
Linkadge
Posted by linkadge on January 5, 2007, at 10:47:31
In reply to re: ECT is this a surprise?, posted by skeptiK on January 5, 2007, at 9:23:34
Its been known for a while that people with Epilepsy often suffer cognitive problems with increasing duration of untreated seizures.
I don't think there is any safe way to induce a seizure.
Linkadge
Posted by Phillipa on January 5, 2007, at 18:32:48
In reply to re: ECT is this a surprise?, posted by linkadge on January 5, 2007, at 10:47:31
Link good point as my Husband's brother had a brain tumor as a teen and still has seizures and he acts like a stroke victim. He is getting worse yearly now 42. Acts like an old man and a child as Christmas is still the biggest day of his life. Other than that he stays home and works on small projects and walks with his head held down. Love Phillipa
Posted by Karen44 on January 5, 2007, at 23:04:22
In reply to re: ECT is this a surprise?, posted by SLS on January 4, 2007, at 20:36:07
I looked carefully at Sackeim's most recent study and then went and looked back at previous studies with which he was involved. Why did I do this? Because ECT has been suggested again, and I agreed to talk to an ECT doctor re this. The long and the short of it is that Sackeim's studies have always been flawed in terms of research design, methodology, and any pre and post testing. This holds true for his most recent study where he reluctantly claims that it is true that one may suffer serious cognitive impairments. First, his supposed use of pre and post neuropsychological testing is basically a bunch of crap. As a psychologist I am aware of the best tests to use to determine if there is verbal and nonverbal cognitive impairment. He used some measures that are by far not the best to use. And, some of his measures are one's he made up himself and that have never been validated. While he now suggests that RUL may be the way to go, even his shoddy testing measures showed cognitive impairment. He glosses over this, however, and instead talks about how with RUL one does not see the memory impairments one sees with bilateral. This is to suggest that nonverbal memory is NOT important. Well it is! Added to this, he is now recommending suprathreshold levels for RUL. What does this mean? It means he is recommending people who get RUL get shocked at 6 to 12 times their seizure threshold level. If you don't think that won't cause both verbal and nonverbal cognitive impairments, think again. The man is a disgrace, but what I find more disgraceful is that psychiatrists do not look at the research to assess just how good is it. No, they seem to just blindly follow Dr. Sackeim because he has always been viewed as the definitive expert on ECT. I saw a video of him where he admitted he made up numbers, that some of his statistics are not based on research. And yet he will continue to be cited and viewed as the preeminent expert.
I would have to have certain conditions agreed to before I would submit to ECT. That would be no more than two treatments per week, RUL, low threshold level of no more than 1.5,and no more than one stimulation per treatment. Of folks who have had ECT, I wonder how many of you even know how many times you were jolted to have a seizure per individual treatment session to ensure you had the "proper" seizure. If one has only a partial seizure, then they zap you again and again until they get the seizure they want. This means one could have four seizures in one session,for example. Enough from me now; the whole thing makes me so angry; I have decided no way am I going to risk my career for something that I believe amounts to repeated assaults on the brain.
Karen44
Posted by blueberry1 on January 6, 2007, at 0:15:12
In reply to re: ECT is this a surprise?, posted by Karen44 on January 5, 2007, at 23:04:22
Well said.
Thank you for your detailed research Karen.
>Enough from me now; the whole thing makes me so >angry; I have decided no way am I going to risk >my career for something that I believe amounts >to repeated assaults on the brain.
>
> Karen44Do people actually lose careers from ECT? Well, I did. How? I don't know. I don't remember. That's ECT for you.
Posted by chiron on January 6, 2007, at 3:05:52
In reply to re: ECT is this a surprise?, posted by skeptiK on January 4, 2007, at 12:14:17
I'm sorry that for some people ECT is so devastating. For me, it was a a miracle. It did in no way hurt my career. In fact, within the last 4 months, I have received two unsolicited job offers & completed 2 classes receiving an A & A-, during which I received 2 ECT series.
Some days I would make it to work by 9:00 after receiving my early morning "shock."
Posted by linkadge on January 6, 2007, at 8:58:40
In reply to re: ECT is this a surprise?, posted by Karen44 on January 5, 2007, at 23:04:22
One is inducing a seizure. I don't think there is any proper way to go about it.
There are still significant risks to ECT, even when it is performed ideally.
I don't think it matters if there are some satisfied ECT patients, I think the risks of ECT are unjustified for such a treatment.
The sucess rate may (or may not) be high, but after the relapse rate is factored in, ECT is not all that great.
You could do methamphetamines for 6 months and get great reusults that would probably leave you relapsing the same time as ECT.
Linkadge
Posted by linkadge on January 6, 2007, at 9:00:12
In reply to re: ECT is this a surprise?, posted by blueberry1 on January 6, 2007, at 0:15:12
People loose a lot because of ECT. Unfortunately, those incharge can pawn most permanant dammage off as the "underlying illness".
Linkadge
Posted by linkadge on January 6, 2007, at 9:02:03
In reply to re: ECT is this a surprise?, posted by chiron on January 6, 2007, at 3:05:52
There exists a lot of unbiased animal research that suggests ECT has the capacity to cause dammage.
Just because it works for somebody does not mean it is not inducing dammage.
Linkadge
Posted by skeptiK on January 6, 2007, at 9:53:29
In reply to re: ECT is this a surprise?, posted by Karen44 on January 5, 2007, at 23:04:22
Well said! But unfortunately most p-docs will just shrug this off, and continue to recommend it for 'severely' depressed cases. Why? Because they don't have any other solutions. When meds fail, they won't suggest or admit that for some of us there are no easy answers. Just more trial and error...
Posted by Karen44 on January 6, 2007, at 15:37:53
In reply to re: ECT is this a surprise?, posted by chiron on January 6, 2007, at 3:05:52
> I'm sorry that for some people ECT is so devastating. For me, it was a a miracle. It did in no way hurt my career. In fact, within the last 4 months, I have received two unsolicited job offers & completed 2 classes receiving an A & A-, during which I received 2 ECT series.
> Some days I would make it to work by 9:00 after receiving my early morning "shock."I have heard this can occur according to my pdoc. I am wondering your age and what sort of ECT did you get. RUL? low threshold level? how many per week? and any other details you would be willing to share. I am still considering it, but the likelihood is slim to none.
Karen44
Posted by Reggie BoStar on January 15, 2007, at 20:46:42
In reply to re: ECT is this a surprise?, posted by skeptiK on January 4, 2007, at 12:14:17
I've seen this report about Sackheim's study before. While I'm no fan of Sackheim, I'm not crazy about the way the media puts a spin on things sometimes.
Here is the title of the article:
"Electroconvulsive Therapy Causes Permanent Amnesia and Cognitive Deficits, Prominent Researcher Admits"
Now here is the quote they lifted from the study:
"[T]his study provides the first evidence in a large, prospective sample that adverse cognitive effects can persist for an extended period.."
Notice in the quote that no mention is made of **permanent** amnesia or cognitive defects. Instead, it says that there were "adverse cognitive defects for an extended period".
Those are two different things. Neither is there an "admission" as the headline suggests - just a statement describing the results.
There is also no mention of whether unilateral or bilateral treatments were observed in the study. New findings suggest that unilateral treatments (one side of the brain only) do not cause any memory deficits at all. Where's THAT in the headline?
Once again, I am no fan of Sackheim and I do believe that ECT can cause cognitive deficits in some cases. But which cases, exactly? Unilateral ECT? Bilateral ECT? What about voltage/current levels and frequency?
There are a ton of variables that can swing the results from beneficial to harmful, and the only thing the headline picked up on was an unspecific reference to "defects" over an "extended" period of time.
I would add that until safe vs. dangerous applications are quantified using existing data (not new patients), ECT should be discontinued.
That having been said, I think the spin in this article's headline constitutes either hysteria or a very active imagination on the part of the reporter.
Another thing to keep in mind is that Sackheim did not get where he is by being stupid. If there is some dangerous issue with ECT that he knows about, he will not come forward with a sudden "admission" of any kind. He will leak the news in a way that will minimize the damage to him. Thus, we can expect to see ambiguous statements like the one in the quote.
Just my opinion. I could be wrong, of course.
Reggie BoStar
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