ECT side effects may be short-term

MANY SIDE EFFECTS linked to memory and thought processes following electroconvulsive therapy (ECT) are transient, according to a new analysis from Trinity College Dublin.

The analysis of more than 80 published studies involving almost 3,000 patients found that cognitive deficits were evident within a few days of finishing a course of ECT, but that several functions returned to baseline within two weeks and improved in some cases after that time.

ECT, which involves applying an electrical charge to the patient’s brain under anaesthetic, has generated controversy, particularly over side effects and issues of patient consent.

“Around 450-500 people per year in Ireland have ECT. The vast majority would have it for treatment-resistant depression,” said Prof Declan McLoughlin, research professor of psychiatry at Trinity and co-author of the new paper with Dr Maria Semkovska.

“The side effects that people have most concern about – public, patients, physicians – are the cognitive side effects that affect memory function or the ability to think and plan. We wanted to look for any study that reported upon a patient’s cognitive function before they had ECT and then again after they finished a course of ECT.”

The researchers identified published studies that used “rigorous, high-quality neuropsychological tests”. They pooled the data to carry out the analysis, which was published online in Biological Psychiatry this month.

The new study could not look at the ability to recall previously learned information, but it indicated that deficits in several other cognitive functions were initially apparent but no longer evident in most patients two weeks after finishing ECT, and for many their function improved after that.

“After 15 days, processing speed, working memory, anterograde memory, and some aspects of executive function improve beyond baseline levels,” stated the paper.

“It demonstrates that people do get cognitive memory side effects but they are transient and, after about two weeks or so, most of these functions will be better than before they had the treatment,” said Prof McLoughlin.

“What physicians and patients can take from it is that ECT does have cognitive side effects but the majority of these are transient.

“It’s also important that patients who are having ECT should be aware they are likely to have these cognitive problems. They shouldn’t be making major financial decisions when they are having the treatment and [should] wait a week or two after they have finished the treatment before making major lifestyle decisions.”

The study received funding from the Health Research Board and the Friends of St Patrick’s University Hospital.