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By Michael Conlon
CHICAGO, Mar 14 (Reuters) - Electric shock therapy, a treatment abused and vilified decades ago, is emerging as a valuable and common tool to combat the most severe forms of depression, researchers reported on Tuesday.
"It is time to bring (the therapy) out of the shadows," remarked Richard Glass, deputy editor of the Journal of the American Medical Association, which published a new report on the subject in this week's edition.
That study, from the New York State Psychiatric Institute, and the College of Physicians and Surgeons at Columbia University, New York, found that a combination of lithium and the antidepressant drug nortriptyline following shock therapy substantially lowered the relapse rate of patients with major depression.
The patients involved were resistant to the usual drug-based depression treatments.
Shock treatment today is known as electroconvulsive therapy. Compared to earlier times it is mild and produces a reaction more like a slight "shiver" according to a spokeswoman for the study's principal author, Harold Sackeim. The procedure, in which convulsion-producing shock waves are sent into the brain of a patient under anesthesia, is now more common than hernia surgery or tonsillectomies, according to information released by the medical association.
In an editorial in this week's journal commenting on the study and the procedure in general, Glass said the therapy got a bad name in the middle part of the last century when abuse led to "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."
IMPROPER USE OF THE THERAPY
Former Senator Thomas Eagleton's disclosure that he had undergone shock therapy forced him from the Democratic party's 1972 presidential ticket as George McGovern's running mate.
The 1975 movie "One Flew Over the Cuckoo's Nest" painted an incorrect picture of shock therapy being used for painful punishment, according to Glass.
The study published on Tuesday was conducted from 1993 to 1998 at the Carrier Foundation, Belle Meade, New Jersey, and at psychiatric facilities at the University of Iowa, Iowa City, and Western Psychiatric Institute and Clinic, Pittsburgh.
The researchers said shock therapy is normally used only in cases where patients are resistant to drugs, but the relapse rate exceeds 50%.
In the study the combination of the two drugs and the therapy cut the relapse rate to 39%. Sackeim said changes in the timing of the drug treatments or in the ways which patients can be weaned off the shock treatments could reduce the relapse rate "down into maybe even the 10% range. That would clearly be an extraordinary accomplishment."
In the editorial Glass said the usefulness of shock treatments for combating depression "are among the most positive treatment effects in all of medicine ... yet this effective treatment too often remains in the shadows of stigma and fear. The study ... is a good example of the growing scientific database that can usefully inform clinical decisions about this treatment."
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