In addition to patient testimony [for and against], the advisory 
panel heard FDA staffers describe their analysis of hundreds of ECT studies.

As a group, the studies tended to be poorly designed and with too few 
patients to allow the drawing of firm conclusions. Many failed to 
follow patients long enough to discover the duration of ill effects. 
Ones done decades ago studied techniques and electricity dosages 
different from current practice.

The FDA staff reported the existing research suggests that for 
depression, ECT is more effective than placebo or "sham" shocks and 
after a month more effective than antidepressants.

In terms of hazards, the FDA staff's review found the treatment is 
associated with "impairment in orientation, memory and global 
cognitive function immediately after ECT and up to 6 months." Certain 
aspects of memory may return to baseline after six months. 
"Autobiographical memory" - recollection of events in one's life - 
appears to be at greatest risk. High-dose electric current and 
current applied to both sides of the brain are associated with more 
thinking and memory problems.

Panel member Christopher A. Ross, a psychiatrist and neuroscientist 
at Johns Hopkins University, asked if the published studies 
identified any risk factors that predisposed patients to memory loss 
and thinking impairment.

"Evidence-based data for that issue just doesn't exist," said Peter 
G. Como, a neuropsychologist at the FDA.

Panel Chairman Thomas G. Brott, a neurologist at the Mayo Clinic's 
campus in Jacksonville, Fla., said he was amazed that essentially no 
research had been done on ECT's effects using functional MRI imaging, 
repeated brain wave (EEG) studies, or autopsy examinations of patients.

"I tried to look and saw very little. I concluded that the evidence 
is not there to decide either way," he said.

<http://www.washingtonpost.com/wp-dyn/content/article/2011/01/28/AR2011012806328_pf.html>http://www.washingtonpost.com/wp-dyn/content/article/2011/01/28/AR2011012806328_pf.html 





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