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Editorial
March 14, 2001

Electroconvulsive TherapyTime to Bring It Out of the Shadows

Author Affiliations

Author Affiliation: Dr Glass is Deputy Editor, JAMA.

JAMA. 2001;285(10):1346-1348. doi:10.1001/jama.285.10.1346

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.

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