David Heath, MB, ChB, FRCPC
Geriatric Psychiatrist
Program for Older Adults
Homewood Health Centre
Guelph, ON
You receive a call from Mrs. Roberts' daughter and she tells you, "They want to give mum shock treatment for her depression. I didn't think they still did that. What do you think doctor? Mum says she doesn't want to sign the consent form without first talking to you." Some physicians might feel put on the spot after such a conversation and are unsure how to respond. They may not have learned much about electroconvulsive therapy (ECT) in medical school and much of what they hear about it in the media is negative and often sensationalised. So, what are the facts about this widely misunderstood treatment?
ECT's voodoo image is not helped by the fact that its mechanism of action is still unknown. The induction of a seizure is universally accepted as necessary for its effectiveness, however, and its origins are quite scientifically respectable. Convulsion, induced by camphor, has been known to "cure insanity" since 1764. Von Meduna started treating schizophrenic patients this way using camphor and then Metrazol in the 1930's. In 1938, Cerletti used electrical stimulation as a less unpleasant convulsant.
