Electroconvulsive therapy (ECT) is a medically safe mental health intervention , according to a new study led by Dr. Tyler Kaster, a researcher at the Center for Addiction and Mental Health, as part of his doctoral studies at the University of Toronto ( Canada).
The study, published in the journal ‘ The Lancet Psychiatry ‘, is one of the largest and most comprehensive in which the safety of electroconvulsive therapy is compared with standard treatment among people with depression .
Multiple studies conducted over decades have confirmed the efficacy of ECT as a mental health intervention for people with treatment-resistant depression. Up to 80% of severely depressed people who receive ECT achieve remission . Yet despite this success rate, only one percent of people with severe depression get it, likely due to concerns about side effects, such as cognitive and medical complications.
This study examined the psychiatric records of more than 10,000 Ontario patients whose depression was severe enough to require at least three days of hospitalization, and compared the risk of medical hospitalization or death within 30 days of patients who received ECT. compared to those who did not.
It concludes that “among individuals hospitalized for depression, there is no clinically significant increased risk of serious medical events with exposure to ECT, while the risk of suicide appears to be significantly reduced.” The benefits of ECT on depression outcomes may outweigh its risks in this population. “
“ECT is the most effective treatment we have in psychiatry for depression,” says Dr. Kaster, a CAMH psychiatrist who treats patients with ECT at CAMH’s Temerty Center for Therapeutic Brain Stimulation. “But the biases and discrimination around treatment are huge in preventing people from accessing it.”
Patients with severe depression are often prescribed antidepressants and / or psychotherapy, but about a third will not respond to these first-line treatments, and will then be diagnosed with treatment-resistant depression.
There are several interventions for this disease, including drug combinations, new drugs such as ketamine, and a neurostimulation treatment called repetitive transcranial magnetic stimulation (rTMS).
However, when these treatments do not lead to improvement or when depression becomes very severe, leading to hospitalization, ECT is often considered the next step , as it is very effective in rapidly reducing symptoms of the disease. depression and suicidal thoughts.
Study corresponding author Dr. Simone Vigod, chief of psychiatry at Women’s College Hospital, notes that the study illustrates the importance of emphasizing the safety and efficacy of ECT as an effective mental health intervention for people in whom nothing else has worked.
“At Women’s College Hospital, we believe that supporting people living with mental illness has never been more important,” she adds. “Doing so requires providing patients with a full spectrum of evidence-based treatments based on rigorous research evidence. This research adds to the body of existing studies on the safety and efficacy of electroconvulsive therapy , which may be a valuable option. for those who suffer from severe depression, “he stresses.
Dr. Kaster believes that the persistent fear associated with ECT is a reflection of the general level of prejudice and discrimination that continues to exist regarding the mental illness itself.