Revisiting Electroshock Therapy

“It was a brilliant cure, but we lost the patient,” Ernest Hemingway remarked famously after receiving electroshock therapy for depression in 1961. Forty years later, a new study finds that the cure rate for the controversial treatment is far from brilliant, even when combined with drug therapy.

In a six-month study of 84 severely depressed adults, psychiatrists in New York found a relapse rate of almost 40% among those who had the electroconvulsive therapy, or ECT, followed by an antidepressant drug regimen. Almost 90% of those who had only ECT plunged back into depression.

Some consider electric shocks to be worthless and gruesome, as it was portrayed in the 1975 movie “One Flew Over the Cuckoo’s Nest.” But many psychiatrists insist the treatment is extremely effective as a last resort for people who don’t respond to drugs. Major depression strikes about 10% of American adults, or about 17 million people, according to most estimates, and many of them simply don’t do well with counseling, drugs or a combination.

In Hemingway’s time, when ECT was used more often as a first choice, psychiatrists boasted a cure rate of about 50%, six months after the treatment was stopped. This study, write the authors, “suggests that the prognosis following ECT is more guarded today.”