Electroconvulsive Therapy (ECT) remains a highly controversial treatment. It involves administering an electric shock to the brain to induce a seizure, with the intention of alleviating mental health conditions, including depression. A typical series involves about ten treatments. ECT is still used on about a million people annually, including about 3,000 in the UK, predominantly women over 60.
ECT advocates and researchers tend to present it as effective and safe. But I have just published an analysis of research studies in which I calculate that the probability of ECT causing a major cardiac event is “between 1 in 15 and 1 in 30 patients”. I concluded that “these cardiac events are a major cause of ECT-related deaths.” [1]
The analysis included six cardiac events: myocardial infarction, life-threatening arrhythmia, acute pulmonary edema, pulmonary embolism, acute heart failure, and cardiac arrest.
ECT proponents sometimes characterise these heart attacks and other cardiac events as “infrequent” and therefore inconsequential. But the electricity and the artificially induced seizures repeatedly place the heart under abnormal strain. Patients and their families have a right to be told of the risks involved. My analysis concludes: “The ethical principle of informed consent is being routinely breached by ECT psychiatrists.”
I feel confident making that assertion because a research team of which I am a member has conducted two audits of the information leaflets given to patients and families, one in England,[2] and the other in the rest of the UK (Northern Ireland, Scotland and Wales).[3] In England the information provided by 30 out of 36 ECT clinics (83%) made no mention at all of cardiovascular side effects. This was the case for 21 of 26 clinics (81%) elsewhere in the UK.
In January, three people who have had ECT, myself and two other psychologists launched the first international survey of people who have had ECT, and their family and friends. We have had over 1,200 responses, from 42 countries. Thus far, 24% report that they were given “adequate information” about ECT. Only 11% say they were told that “ECT can cause heart problems.”
Other interesting findings include that 45% think ECT improved the condition for which it was prescribed (typically depression) but 36% thought it had made things worse. Eight percent said they would want to have ECT again if needed, 17% were not sure, and 75% would not want to have it.
The survey closes in two weeks on September 30, 2024. In the time remaining, please help us give even more people a say, by disseminating the link to the survey among your mental health networks, mental health NGOs in your country and on your social media platforms. Positive, negative and mixed experiences all welcome.
I will summarize the final results here, in 2025, after they have been published in scientific journals.
