Is ECT an Acceptable Form of Psychiatric Treatment?

My field of interest is in medicine, with a specific interest in the human brain and mind; the brain being a physical thing, and the mind being an intangible entity. Because the brain and mind cannot exist without one another, many problems arise in biological, chemical and psychological aspects when complications occur in one of these. Some of these complications may include depression, schizophrenia and other mental disorders. Nowadays, there is an abundance of pharmaceuticals that physicians prescribe to treat these. What happens when they don't work?     

Electroconvulsive/Electroshock Therapy (ECT)
ECT is a form of rehabilitation typically used to treat mental health patients suffering from long-lasting depression and/or schizophrenia. Currently, when ECT is given to patients, it is mainly utilized after exhausting all other psychotherapy and medication options. To begin, patients are first issued intravenous antesthethics. Electrodes are then placed over specific regions of the brain, and electrical waves are sent in order to produce seizure. These seizures generally last approximately thirty to ninety seconds. If a convulsion should last longer than three minutes termination is suggested. After twenty to forty minutes post-treatment, a patient is usually awake and stable. Throughout course of treatment patients are observed closely by a group of medical professionals.

PRO ECT:

• Currently, when ECT is given to patients, it is generally utilized as a last resort form of therapy. The only time this form of therapy is truly ever considered as a frontline regimen for a patient is if they are suicidal, manic depressive, or have lived with chronic depression for many years.
• ECT is safer. Despite the adverse affects that ECT may cause an individual, through research, it has been recognized that the most secure and conducive way to apply convulsions as a type of therapy is through electrical agitation. Research in the last ten years has also deduced that contrary to previous belief, unilateral (one-sided) ECT has proven to be just as proficient as bilateral (two-sided) ECT, but with a more limited effect to cognitive dysfunction. Electroconvulsive therapy has also found to be a method that is safe and effective during pregnancy unlike many of the drug therapies that are discouraged in those nine months.   
• ECT is effective. There are possible causations for detrimental effects, but it is rare that a person who has undergone electroconvulsive therapy will be traumatized long-term with these repercussions. It is also important to understand that once a person has completed a course of ECT, most will either continue with the treatment, be put on some form of antidepressant or mood stabilizer, or will consider another form of maintenance treatment

OPPOSE ECT:

• Much contention towards ECT is due to negative images created by movies such as One Flew Over the Cuckoo's Nest. In reality, patients are not coerced into this treatment, nor are they awake and flailing arms all over the table. 
• ECT is expensive. Each treatment of ECT may cost anywhere between $300 and $800 for services of a psychiatrist, anesthesiologist, nursing team, the actual treatment, and miscellaneous hospital charges. Most patients that are prescribed electroshock for therapy, experience it the treatment numerous times which can quickly add up. Although some health insurances may cover costs, many people today cannot even afford coverage for their health. 
• ECT may cause slight cognition loss. Anywhere up to several months after persisting through treatment, a patient may experience retrograde amnesia, depletion in some cognitive functioning, or suicidal ideation and thoughts. More often than not, this memory deficit will only affect the patient’s recollection of the procedure or events encompassing the weeks nearby. Studies have shown that both loss of memory and cognitive functionality could be due to placement of electrodes, magnitude and wave classification of electricity, recurrences of regimen, and undetected medical circumstances. An electroencephalogram (EEG), which is an electrode cap used to measure and record brain electrical activity, will show that mental operations are in fact moving at a slower rate for up to three months. It has also been gathered that a patient with more than one personality disorder is less likely to have a pronounced recovery. 
• ECT may be fatal. Although the death rate, due primarily to cardiac arrhythmia, has decreased from 0.1 percent in the year 1950 to less than 2 for 100,000 ECT treatments (Panksepp, 2004), this is still a risk that patients have to factor into their decision-making plans for recovery.

My opinion:
I believe that electroshock therapy is an acceptable form of treatment as it stands. As stated previously, it is rarely used as an initial procedure and is only really used as a last resort after an extensive amount of psychotherapy and such. As for the anti-shock activists, there is no such thing as cheap treatment for anything anymore. There is also never a total guarantee that a person will wake up after all procedures.   


References:

• Breggin, P. R. (2008). Electroconvulsive Therapy (ECT) for Depression. In P. R. Breggin, Brain-Disabling Treatments in Psychiatry (pp. 217-251). New York, NY: Springer Publishing Company, LLC.
• Figiel, G. S., McDonald, W. M., McCall, W. V., & Zorumpski, C. (2001). Electroconvulsive Therapy. In A. F. Schatzberg, & C. B. Nemeroff, Essentials of Clinical Psychopharmacology (pp. 327-349). Washington, DC: American Psychiatric Publishing, Inc.
• informed consent. (2010). Retrieved November 2010, from Encyclopaedia Britannica Online: http://www.britannica.com/EBchecked/topic/1407801/informed-consent
• Janicak, P. G., Davis, J. M., Preskorn, S. H., & Ayd Jr., F. J. (2001). Treatment with Electroconvulsive Therapy and Other Somatic Therapies. In P. G. Janicak, J. M. Davis, S. H. Preskorn, & F. J. Ayd Jr., Principles and Practice of Psychopharmacotherapy - Third Edition (pp. 327-362). Philadelphia, PA: Lippincott Williams & Wilkins.
• Kneeland, T. W., & Warren, C. A. (2002). Pushbutton Psychiatry: A History of Electroshock in America. Westport, CT: Praeger Publishers.
• National Alliance on Mental Illness. (1996-2010). About Mental Illness. Retrieved November 2010, from National Alliance on Mental Illness: http://www.nami.org/Content/NavigationMenu/Inform_Yourself/About_Mental_Illness/About_Mental_Illness.htm
• Panksepp, J. (2004). Somatic Treatments in Psychiatry. In J. Panksepp, Textbook of Biological Psychiatry (pp. 522-525). Hoboken, N.J.: John Wiley & Sons, Inc.
• Sackeim, H. A. (1989). The Efficacy of Electroconvulsive Therapy in the Treatment of Major Depressive Disorder. In S. Fisher, & R. P. Greenberg, The Limits of Biological Treatment for Psychological Distress (pp. 275-307). Hillsdale, N.J.: Lawrence Erlbaum Associates, Inc.
• Shorter, E., & Healy, D. (2007). Shock Therapy: A History of Electroconvulsive Treatment in Mental Illness. Piscataway, N.J.: Rutgers University Press.