Electroconvulsive Therapy

Information on Electroconvulsive Therapy

Home - ECT Therapy - Electroconvulsive Therapy – A History

Electroconvulsive Therapy – A History

Posted on August 8, 2011 in ECT Therapy

Fact is, recorded medicine history links electric shock to pain relief. With electric shock therapy, history mentions that ever since antiquity, the effect of electroshocks was known to “doctors” of old. Aristotle and Pliny the Old mentioned the effects of the electrical discharges of the torpedo fish. From Scribonius Largus, we have a description of gut pain relief using this fish. Dioscorides and then Galen recommended the fish’s discharges for headaches.

More than a millennium and a half passed from when the Dark Ages left science until it started to evolve again. Christian Gottlieb Kratzenstein (said to be the model for the Dr. Frankenstein), a medic, professor at Halle University and an engineer, recorded his first observations of electricity use in medicine at the end of the 17th century. Then, a physics professor from Geneva, Jean Jallabert, observed – by chance – that by applying electroshocks with a Leyden jar, he could stimulate muscle regeneration and blood increase in a locksmith’s paralyzed hand; electroconvulsive therapy history began its germination – it was in 1746 when the use of electricity in medicine was first described in printed work.

Almost a century later, a Frenchman took the scientific lead. Guillaume Benjamin Armand-Duchenne, an MD from Boulogne, was not very fond of his job. As one misfortune never really comes alone, his wife died, he failed in a second marriage, and he eventually abandoned his child. He fell into a deep depression and neglected his patients.

Duchenne was fascinated with the effect of electricity over muscular fiber contraction. It was the spark that lighted his genius. Probably – as a side effect during experiments on himself, he would realize only later – the electric shock treatment reduced his depression and restored his will.

With a renewed passion for life and medicine, Duchenne moved to Paris. He continued his research over electrical stimulation on disordered nerves or muscles, and he is accredited with a series of important discoveries: identification of tabes dorsalis, muscular atrophy, biopsy, mapping the facial muscles and electrotherapy (1846). Considered a bit strange, Duchenne used to carry with him a Faraday unit during all his medical visits.

Almost one century later, in 1937, an Italian neurologist called Ugo Cerletti was studying epilepsy. He knew from medical literature that electric shocks produce epilepsy-like convulsions and wanted to cure the disease with Electroconvulsive Therapy (ECT). Cerletti’s research was conducted against the research regarding insulin-provoked convulsions which were very similar to epilepsy. His idea was that electricity would annihilate epilepsy seizures. He got to this conclusion when he saw pigs being cataleptic after electroshocks before being slaughtered, and he was the first one to use electric shock therapy treatment.

Later on, other scientists discovered that ECT treatment had notable effects over patients with affective disorders. Some of them approximated the rate of effectiveness up to 90% of the cases. This discovery paved the way to an alternative therapy for depression.

The end of the Second World War brought ECT in treating veterans with post-traumatic disorders. Psychiatrists soon found out that for a duration of three weeks maximum, with three sessions a week, were sufficient to significantly improve their patients’ mental states.

Because of the severe injuries reported during “regular” ECT (broken bones, torn muscles, even broken spines), specialists tried different drugs to reduce or even eliminate convulsions.

A simple description of the procedure is that low and medium DC currents (200 mA to 1,6 A and 70 to 400 V) are conducted through the patient’s brain for a very short time (0.1 to 5 seconds).

Neurotransmitters (brain chemicals) are positively influenced by ECT, and, as they send improved messages from one neuron to another, the brain cells will work better together, and the general mood of the patient improves.

This therapy treatment for depression gained momentum in the 50’s and the 60’s, to diminish during the 70’s and 80’s, due to newly discovered neuroleptics, which induce tranquility and affective stability. Press campaigns and movies like One Flew over The Cuckoo’s Nest seemed to strike a decisive blow against ECT.

Nevertheless, the method was not abandoned. One of the reasons is the fact that it is not addictive unlike neuroleptics. On the contrary, the patient has to be subjected to the procedure only every few months, to avoid recession.

Pharmaceutical science and medicine have made important improvements. In order to reduce the risk of injuries, patients are either anesthetized on short term, or they are given muscular relaxants. During ECT, they are pre-oxygenated. For the sake of better care, an EEG monitors their brain function. Plus, other devices have been developed, and more subtle electroshocks have been innovated, making ECT psychiatric treatment a more efficient and a less damaging method.

In the United States, psychiatric statistics approximate the total number of ECT subjects to 100,000 to 150,000 people a year. Recently, actress Carrie Fisher, Princess Leia from Star Wars, publicly confessed she got out of depression through ECT. Another famous figure, writer Paulo Coelho, admitted he tried to calm his torments through ECT.