Electroconvulsive therapy not damaging to memory -- early results

Severely depressed elderly Victorians are benefiting from electroconvulsive therapy (ECT) -- and, contrary to popular belief, the treatment is not damaging their memories, a Monash University study has found.

The head of the university's Aged Mental Health Research Unit, Professor Daniel O'Connor, said early results of the study show ECT produces dramatic improvements in depressed patients -- with no significant decline in memory.

The treatment was first used in the 1930s, mainly to treat schizophrenia. Today, it involves a weak electrical current being applied to one (unilateral) or both sides (bilateral) of the head. A seizure follows with minor muscle spasms.

"Many people are frightened of the idea of ECT today because of the image it conjures -- such as Jack Nicholson in One Flew Over the Cuckoo's Nest -- and the terrible conditions that applied in some mental hospitals in the past," Professor O'Connor said.

"But today, ECT is administered with a general anaesthetic and is a short procedure which can really help severely depressed elderly people who have not responded to the usual anti-depressant medications and are otherwise at risk of dying of starvation and dehydration because of a refusal to eat or drink."

Professor O'Connor said there was a general perception that memory was worse after shock therapy, but his was the first study specifically on memory changes in older people.

His study, based at the Kingston Centre in Cheltenham, is examining the effect of ECT on patients in acute aged psychiatry units in southeast Melbourne. So far, 15 patients have completed the project through to the three-month follow-up stage. All have received unilateral ECT.

The patients have brief cognitive tests during and after a course of the treatment, and participants and relatives are asked for their own assessment of the patient's memory.

"The results are only provisional, but it does appear there has not been any objective decline in memory following unilateral ECT, although some participants and relatives report a subjective deterioration in memory for reasons that we do not yet understand," Professor O'Connor said.

He said they would learn more about the effects of bilateral ECT on memory -- which is still administered in some centres in Australia - as more participants were recruited.

http://www.monash.edu.au