Author Affiliation: Dr Glass is Deputy Editor, JAMA.
Electroconvulsive therapy (ECT) is one of the most controversial treatments
in all of medicine. There are a number of reasons for this. The discovery
in the 1930s that inducing a series of generalized seizures, initially with
chemicals,1 later with electric current,2 could cause the recovery of patients with severe and
previously untreatable mental disorders produced a wave of enthusiasm that
eventually led to a period of indiscriminate use and misuse in the middle
decades of the 20th century.3,4
This period of abuse created, perhaps deservedly at that time, a bad reputation
for an effective treatment modality. That reputation was enhanced by the immediate
adverse effects of bitten tongues and even fractured bones and teeth caused
by the induction of generalized seizures, and the painful effects of electroshocks
administered without anesthesia when they did not successfully induce a seizure
with loss of consciousness.
Glass RM. Electroconvulsive TherapyTime to Bring It Out of the Shadows. JAMA. 2001;285(10):1346-1348. doi:10.1001/jama.285.10.1346