There was a very informative article in the “Washington Post” on July 24 (click here to view the entire piece) about electroconvulsive therapy–how it continues to save lives, but is still controversial mostly because of the memory loss that can occur.
I’m intrigued by ECT because my doctor and I discussed that as an option if the medication combination I was on (number 23) didn’t work.
Here are some excerpts from the Post article:

Better known as shock therapy and seared into our collective consciousness as the involuntary procedure depicted in “One Flew Over the Cuckoo’s Nest,” electroconvulsive therapy remains a controversial treatment, often used, as in Mauger’s case, only after other treatments fail. Its popularity has waxed and waned in its 70-year history, but an estimated 100,000 Americans undergo ECT each year, according to a 1995 survey of more than 17,000 psychiatrists, and its use appears to be steady or increasing since then.
The number of treatments in California — one of the few states that have mandatory reporting — increased from about 13,000 to more than 20,000 between 1994 and 2004. Although the District, Maryland and Virginia do not require such reporting, Johns Hopkins Hospital treats about 125 people with ECT annually, a number that has not changed much recently, according to Irving Reti, head of Hopkins’s ECT unit; at Sheppard Pratt outside Baltimore, ECT physician Jack Vaeth says his service does about 60 treatments a week, an increase over the past decade.

While no one fully understands why ECT works, many psychiatrists believe that using an electric current to produce a “grand mal” — or generalized brain — seizure can “reboot” the brain when medications and psychotherapy fail. Just last week, a commentary in the Journal of the American Medical Association (JAMA) suggested that, despite its demonstrated effectiveness, ECT remains underused, primarily because of its stigmatized history.

The treatment is “miraculous” and “lifesaving,” say some patients and doctors, and yet the costs — primarily memory loss — can be significant. Many individuals who believe that ECT kept them alive when they were suicidal also urge caution about its use.
Mauger, as an older individual with “treatment-resistant” depression, is a fairly typical patient. Initially scared, he decided to try ECT weeks after his psychiatrist and wife first urged him to. By the seventh of his 12 treatments, he felt his depression lift.
“He sat up and said, ‘I’m not depressed anymore,’ ” his wife said. “I was amazed.”
His one relapse years later quickly responded to another course of treatment. “I am terrified of what would have become of me without ECT,” Mauger says.
An acute course of treatment usually comprises eight to 12 sessions, administered two or three times a week at a hospital. Studies show that more than 70 percent of severely depressed patients experience quick improvements. (About 50 to 60 percent respond to antidepressants.)
ECT is hands-down, for the short term, our most effective treatment for depression,” says Harold Sackeim, professor of psychiatry and radiology at Columbia University.

However, only about half of patients remain well even six months after one course, if given no other treatment afterward. “Acutely helping someone out of a period of depression is very important,” says Sarah Lisanby, chairperson of the American Psychiatric Association Committee on ECT and Related Treatments. “But it’s not the end of the story. The goal is long-term treatment.”
That goal is a priority for researchers. The first randomized, controlled study of maintenance treatment following ECT, published in 2001, found that giving patients a combination of an antidepressant and a mood stabilizer significantly increased the chances that they would not relapse into major depression six months after having ECT.
More recently, a research group found that continuing to give ECT once a week to once a month for six months produced results similar to the combination medication treatment.
“We’re learning how to keep people well after ECT more than we knew before,” said Max Fink, professor emeritus of the Departments of Psychiatry and Neurology at Stony Brook University in New York, who wrote last week’s commentary in JAMA. “You can’t just stop.”