Electroconvulsive therapy effectiveness and harm

Dr Tracy states that there is no reliable and convincing evidence with regard to the effectiveness of electroconvulsive therapy (ECT) (forgetting why, remember how), and then continues by saying that ECT critics are ‘…folk [who] are curiously happy with anecdote when it comes to harms'.¹ Curiously, in the light of the acknowledged uncertainty of the evidence base regarding effectiveness and, I would add, seriousness of adverse effects, Dr Tracy omits to explain the basis upon which proponents of ECT continue to practice this intervention on a relatively large scale (perhaps on anecdote when it comes to ‘good' outcome?). But, we do have some evidence through systematic reviews that ECT is not effective beyond the treatment period.^{2, 3} There is little or nothing in the literature to suggest that ECT ‘saves lives’ or that it prevents suicide, as it is often repeated. In fact, a study by ECT advocates found an overall increased rate of suicide in patients treated with ECT.⁴ With regard to other harm done, a large study carried out by ECT-advocate Harold Sackeim revealed highly significant cognitive dysfunctions (memory loss and other impairment of cognitive functioning) in 347 patients tested 6 months after ECT, as well as persistent electro-encephalogram abnormalities, indicating the presence of persistent brain damage.⁵