rugosa at escape.com (floribunda) writes:
>This is the first and only informed consent statement about shock
>treatment (ECT) written by persons who had shock.
I think that's a great idea. There's one part I'm not so sure about,
though. I've never had ECT, but I've read about its effects on the
brain, and this bit here seems a little misleading:
> ECT is one of a number of drastic psychiatric treaments, including
>insulin coma and psychosurgery, that relieve suffering temporarily. All of
>them "work" by destroying brain tissue. That is their common denominator.
ECT has been shown to induce changes in the sensitivities of receptors
for all the monoamines, and acetylcholine, endogenous opiates, and
other neurotransmitters. ECT also alters the release of some of those
neurotransmitters. Effects like that may mean that ECT is more
comparable to antidepressant drugs (which induce similar changes in
neurotransmitter systems) than to surgery.
MRI scans have shown only brief changes in brain tissue after ECT;
those changes peak at two hours post-treatment and reverse within 24
hours. They may reflect temporary alterations in the blood-brain
barrier. (My source for this is a review in the January '93
_Psychiatric Annals_.)
In any case, I sure don't know of any evidence that the efficacy of
ECT is associated with structural alterations in the brain. It's
entirely possible that a successful course of ECT may not involve any
brain-tissue loss at all. I suspect that any honest psychiatrist
would admit that no one is quite sure how ECT works.
--David
