A survey of 1144 ECT recipients, family members and friends: does ECT work?

The last placebo-controlled ECT trial for depression occurred in 1985. While awaiting trials meeting today’s standards of evidence-based medicine, this paper presents the responses, to an online survey, of 858 ECT recipients and 286 family members and friends, from 44 countries, on five effectiveness measures. The majority (55% to 71%) received either no benefit or a negative outcome on the five measures. The percentages reporting some benefit were: helped the problem for which ECT was given - 45%; improved mood - 41%; ‘helpful’ - 41%; improved ‘quality of life’ - 29%; reduced suicidality - 33%. Respondents were, unusually, given the option, on four of the measures, to report that the variable had been made worse. The results were: specific problem made worse – 37%; worse mood – 29%; reduced quality of life – 62%; and increased suicidality – 19%. The findings were consistent with responses from family and friends. It is striking that nearly half (49.1%) reported that their quality of life was made ‘much worse’ (21.6%) or ‘very much worse’ (27.5%) by ECT. A partial explanation of this alarming outcome is that quality of life encompasses the adverse effects of ECT alongside any benefits. In conjunction with the absence of evidence that ECT is more effective than placebo, and the known long-term adverse effects on memory, these survey findings lead us to recommend an immediate suspension of ECT in clinical settings pending independent large-scale placebo-controlled studies to determine whether ECT has any effectiveness relative to placebo, against which the many serious adverse effects can be weighed.