9 ms·

The most dangerous placebo. Please never allow yourself, or your loved ones to be subject to this. You have power within yourself.

Analemma_ 7y ago
Your comment is dangerous and irresponsible. This is not the 40’s, ECT is not used lightly; it is the treatment of last resort for severe depression when lifestyle changes, medication and therapy have all failed. The side effects are well-understood and patients who choose ECT do so because the alternative is unbearable. What you are saying cashes out to the claim that depression can be overcome with sheer positivity and willpower, which is a view I really thought society had gotten over. Please post more responsibly.
- CoffeeInMyCup 7y ago
  Thank you. I've seen the effects of severe depression first hand. It's not a matter of just needing to smile more, it's a serious medical condition that requires professional intervention. To anyone reading this, if you think you're depressed, please seek out a qualified talk therapist (CBT has been shown to be effective in treating depression) and a qualified physiatrist for medication.
- imperio59 7y ago
  Sorry but there are dozens of studies and hundreds of reports of people basically losing memories of entire portions of their life and the ability to do simple things like tie their shoelaces or do simple math after just one round of ECT. How this is still not banned by the FDA is beyond me. Not to mention the number of people who get heart complications from it or outright die during the procedure. How can you say that "the alternative is unbearable"is beyond me, unless you're saying it's better to become mentally disabled than suffer from depression? The argument that "this is not the same ECT" is also bogus. The difference is now they paralyze you so you don't convulse and break your bones while doing it. They also use a higher voltage (more damaging to brain cells) and higher frequencies with shorter, repeated bursts (also causes more brain damage and hemorrhaging). But it's "better" because the patient doesn't thrash around so much anymore. Give me a break. Summary of the issues with ECT and associated studies: https://truthaboutect.org/ect-causes-brain-damage-a-review-of-the-literature/ https://truthaboutect.org/ect-causes-brain-damage-a-review-o... http://emord.com/blawg/wp-content/uploads/2016/08/1-ECT-Citizen-Petition.pdf http://emord.com/blawg/wp-content/uploads/2016/08/1-ECT-Citi...
  - depressed 7y ago
    Have you ever had someone close to you commit suicide? If so, is that truly a better outcome than undergoing ECT? If not, then I want you to understand this: ECT is used to treat a lethal illness.
    - imperio59 7y ago
      I'm sorry but that's the equivalent of saying "This person is about to kill themselves, so let's take a bat and hit them over the head with it so they can't do that now. See, now they're doing fine, they're not killing themselves." Would you take someone who is about to kill themselves and take a pair of live electric wires to their head to try to "cure" them? Because that's essentially what ECT is, despite all the supposed "new and improved" spiel which is marketing speak, that and they sedate you while doing it. Inducing brain damage is not treatment. Saying that is not denying the problems that some people are suicidal and need help. That's a very real issue. But ECT is very real scientific fraud, often done without fully informed consent on the parts of the patients and family members, often done against and over the wishes of the person receiving ECT, and billed for thousands of dollars to insurance companies over and over again, with results that go away once treatment stops and side effects that remain for a lifetime.
      - rincebrain 7y ago
        Most forms of treatment, in terms of therapy, psychiatric medication, or more invasive options, cease to be effective when they're removed, eventually. ECT and ketamine, for example, are sometimes found to be effective for O(months) after initial more frequent treatment, while most of the psychiatric meds you run through earlier if you're pursuing that type of treatment take weeks to become effective (or not), weeks to stop, and the beneficial effects often stop much sooner than the side effects after taking them (...if they stop at all, in some cases). ECT can and often does do lasting damage. It should not be used lightly. But singling out ECT for being a recurring treatment seems unreasonable when the other avenues of treatment, both behavioral and otherwise, have the same caveat.
      - nickbarnwell 7y ago
- devoply 7y ago
  Not particularly last resort. And apparently there is a large line-up in the system for people to get this therapy. They claim that there is a lot of efficacy... but apparently for many the symptoms return over time. The author of the article concludes: "Despite the discomfort and the temporary memory loss it caused, I would have ECT again without hesitation." Much of psychiatry to me seems like an infant mad science but some of the stuff does have efficacy and if it's going to marginally improve the lives of people who can no longer exist normally in the world, then that's possibly the lesser of two evils.
  - nickbarnwell 7y ago
    It really is the last resort; even if you were able to find a psychiatrist willing to administer a course of it without extensive trials of multiple classes of psychotropic medication as an adjunct to psychotherapy, your insurer is definitely not going to spring for it. The NHS’ NICE guidelines outline what’s to be considered before ECT is even proposed (https://www.nice.org.uk/guidance/cg90/chapter/1-Guidance#sequencing-treatments-after-initial-inadequate-response https://www.nice.org.uk/guidance/cg90/chapter/1-Guidance#seq...), and criteria are at least as stringent in the US.
  - rincebrain 7y ago
    A lot of medicine is rather more grey than black and white than we'd prefer, since we either find things out through long tails of researching lots of things and seeing what works better than placebo, or by verifying unexpected reported outcomes (several entire classes of medications have come from unexpected side effects - Rogaine and Viagra were blood pressure meds, the entire SS*I class of drugs was found when someone noticed by accident that a type of antihistamine seemed to improve malaise in some patients, ketamine is rather well known at this juncture as an anesthetic and party drug that got signoff as a novel antidepressant...), and observational evidence isn't necessarily predictive of how it happens on its own. You're not wrong that a lot of psychiatric medications are "this seems to work, who knows why" and experiments around testing mutations on those things to see if they're more or less effective, because we have so little visibility into the brain and cognition that we can't really gauge these things objectively v. well. But for people with pathological brain problems, big unpredictable hammers can be a reasonable choice to try if you have an urgent need for mitigation (e.g. acutely self-destructive problems) and/or less invasive things like directed behavioral therapies have not proven sufficiently effective.
rincebrain 7y ago
I've had (unipolar) ECT done, many times, and it didn't work even marginally for me. It wasn't a forced option, either - I wasn't in an environment where anyone was compelling me, directly or indirectly, to do it, or threatening to do something if I didn't, it was just another option presented to me. I still don't think it's just a placebo - there's pretty good evidence that it's effective for a number of people, both in the small population of others I know who have had it done and outside of that, even though it wasn't helpful for me. It also wasn't obviously deeply destructive for me, either - I don't remember the particular days that this was done well (and didn't even a few days after the fact), but I and others haven't noticed any memory or activity issues outside of that. Do you have specific documentation of why you have these strong opinions?
8fingerlouie 7y ago
Does it matter if it is a placebo if it works ? I have personally witnessed a psychotic manic patient, who by her own account was _not_ sick, undergo treatment, and be completely free of mania and psychosis in 3-4 hours.
cozzyd 7y ago
It's certainly no placebo; it results in immediate (if somewhat temporary) mood changes in many cases. Most of the side effects are probably from the general anesthesia rather than the induced seizures. One problem with ECT is that many psychiatric medicines (e.g. lamotrigine) are also anticonvulsants so it requires stopping or reducing doses of those medicines which can cause problems.

Analemma_ 7y ago

Your comment is dangerous and irresponsible. This is not the 40’s, ECT is not used lightly; it is the treatment of last resort for severe depression when lifestyle changes, medication and therapy have all failed. The side effects are well-understood and patients who choose ECT do so because the alternative is unbearable. What you are saying cashes out to the claim that depression can be overcome with sheer positivity and willpower, which is a view I really thought society had gotten over. Please post more responsibly.

CoffeeInMyCup 7y ago
Thank you. I've seen the effects of severe depression first hand. It's not a matter of just needing to smile more, it's a serious medical condition that requires professional intervention. To anyone reading this, if you think you're depressed, please seek out a qualified talk therapist (CBT has been shown to be effective in treating depression) and a qualified physiatrist for medication.
imperio59 7y ago
Sorry but there are dozens of studies and hundreds of reports of people basically losing memories of entire portions of their life and the ability to do simple things like tie their shoelaces or do simple math after just one round of ECT. How this is still not banned by the FDA is beyond me. Not to mention the number of people who get heart complications from it or outright die during the procedure. How can you say that "the alternative is unbearable"is beyond me, unless you're saying it's better to become mentally disabled than suffer from depression? The argument that "this is not the same ECT" is also bogus. The difference is now they paralyze you so you don't convulse and break your bones while doing it. They also use a higher voltage (more damaging to brain cells) and higher frequencies with shorter, repeated bursts (also causes more brain damage and hemorrhaging). But it's "better" because the patient doesn't thrash around so much anymore. Give me a break. Summary of the issues with ECT and associated studies: https://truthaboutect.org/ect-causes-brain-damage-a-review-of-the-literature/ https://truthaboutect.org/ect-causes-brain-damage-a-review-o... http://emord.com/blawg/wp-content/uploads/2016/08/1-ECT-Citizen-Petition.pdf http://emord.com/blawg/wp-content/uploads/2016/08/1-ECT-Citi...
- depressed 7y ago
  Have you ever had someone close to you commit suicide? If so, is that truly a better outcome than undergoing ECT? If not, then I want you to understand this: ECT is used to treat a lethal illness.
  - imperio59 7y ago
    I'm sorry but that's the equivalent of saying "This person is about to kill themselves, so let's take a bat and hit them over the head with it so they can't do that now. See, now they're doing fine, they're not killing themselves." Would you take someone who is about to kill themselves and take a pair of live electric wires to their head to try to "cure" them? Because that's essentially what ECT is, despite all the supposed "new and improved" spiel which is marketing speak, that and they sedate you while doing it. Inducing brain damage is not treatment. Saying that is not denying the problems that some people are suicidal and need help. That's a very real issue. But ECT is very real scientific fraud, often done without fully informed consent on the parts of the patients and family members, often done against and over the wishes of the person receiving ECT, and billed for thousands of dollars to insurance companies over and over again, with results that go away once treatment stops and side effects that remain for a lifetime.
    - rincebrain 7y ago
      Most forms of treatment, in terms of therapy, psychiatric medication, or more invasive options, cease to be effective when they're removed, eventually. ECT and ketamine, for example, are sometimes found to be effective for O(months) after initial more frequent treatment, while most of the psychiatric meds you run through earlier if you're pursuing that type of treatment take weeks to become effective (or not), weeks to stop, and the beneficial effects often stop much sooner than the side effects after taking them (...if they stop at all, in some cases). ECT can and often does do lasting damage. It should not be used lightly. But singling out ECT for being a recurring treatment seems unreasonable when the other avenues of treatment, both behavioral and otherwise, have the same caveat.
    - nickbarnwell 7y ago
devoply 7y ago
Not particularly last resort. And apparently there is a large line-up in the system for people to get this therapy. They claim that there is a lot of efficacy... but apparently for many the symptoms return over time. The author of the article concludes: "Despite the discomfort and the temporary memory loss it caused, I would have ECT again without hesitation." Much of psychiatry to me seems like an infant mad science but some of the stuff does have efficacy and if it's going to marginally improve the lives of people who can no longer exist normally in the world, then that's possibly the lesser of two evils.
- nickbarnwell 7y ago
  It really is the last resort; even if you were able to find a psychiatrist willing to administer a course of it without extensive trials of multiple classes of psychotropic medication as an adjunct to psychotherapy, your insurer is definitely not going to spring for it. The NHS’ NICE guidelines outline what’s to be considered before ECT is even proposed (https://www.nice.org.uk/guidance/cg90/chapter/1-Guidance#sequencing-treatments-after-initial-inadequate-response https://www.nice.org.uk/guidance/cg90/chapter/1-Guidance#seq...), and criteria are at least as stringent in the US.
- rincebrain 7y ago
  A lot of medicine is rather more grey than black and white than we'd prefer, since we either find things out through long tails of researching lots of things and seeing what works better than placebo, or by verifying unexpected reported outcomes (several entire classes of medications have come from unexpected side effects - Rogaine and Viagra were blood pressure meds, the entire SS*I class of drugs was found when someone noticed by accident that a type of antihistamine seemed to improve malaise in some patients, ketamine is rather well known at this juncture as an anesthetic and party drug that got signoff as a novel antidepressant...), and observational evidence isn't necessarily predictive of how it happens on its own. You're not wrong that a lot of psychiatric medications are "this seems to work, who knows why" and experiments around testing mutations on those things to see if they're more or less effective, because we have so little visibility into the brain and cognition that we can't really gauge these things objectively v. well. But for people with pathological brain problems, big unpredictable hammers can be a reasonable choice to try if you have an urgent need for mitigation (e.g. acutely self-destructive problems) and/or less invasive things like directed behavioral therapies have not proven sufficiently effective.

rincebrain 7y ago

I've had (unipolar) ECT done, many times, and it didn't work even marginally for me. It wasn't a forced option, either - I wasn't in an environment where anyone was compelling me, directly or indirectly, to do it, or threatening to do something if I didn't, it was just another option presented to me. I still don't think it's just a placebo - there's pretty good evidence that it's effective for a number of people, both in the small population of others I know who have had it done and outside of that, even though it wasn't helpful for me. It also wasn't obviously deeply destructive for me, either - I don't remember the particular days that this was done well (and didn't even a few days after the fact), but I and others haven't noticed any memory or activity issues outside of that. Do you have specific documentation of why you have these strong opinions?

8fingerlouie 7y ago

Does it matter if it is a placebo if it works ? I have personally witnessed a psychotic manic patient, who by her own account was _not_ sick, undergo treatment, and be completely free of mania and psychosis in 3-4 hours.

cozzyd 7y ago

It's certainly no placebo; it results in immediate (if somewhat temporary) mood changes in many cases. Most of the side effects are probably from the general anesthesia rather than the induced seizures. One problem with ECT is that many psychiatric medicines (e.g. lamotrigine) are also anticonvulsants so it requires stopping or reducing doses of those medicines which can cause problems.