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Study: Electroshock therapy more successful for depression than ketamine

today.uconn.edu

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Re: Study: Electroshock therapy more successful for depression than ketamine

#51

Post by operator-name »

stevenalowe wrote: post #3

“The side effect profiles of the two treatments differed, with ECT more likely to cause headaches, muscle pain and memory loss, while ketamine was more likely to cause dissociative symptoms, vertigo and double vision.” I’ll take milder effects over pain and memory loss, thanks. No mention of longevity of effect, or specific studies and who paid for them.

I think it's very reasonable to reject one method of treatment just from the side effects alone. I also think it's important to look at the "risk/reward" by looking at how much more effective ECT was against ketamine.

> The overall pooled SMD for depression symptoms for ECT when compared with ketamine was −0.69 (95% CI, −0.89 to −0.48; Cochran Q, P = .15; I2 = 39%), suggesting an efficacy advantage for ECT compared with ketamine for depression severity.

> Both ketamine and ECT had unique adverse effect profiles (ie, ketamine: lower risks for headache and muscle pain; ECT: lower risks for blurred vision, vertigo, diplopia/nystagmus, and transient dissociative/depersonalization symptoms).

Perhaps you'd reach the same conclusion as you did, and I think the paper puts it best:

> Although ECT may be more efficacious than ketamine in the acute phase, treatment options should be individualized and patient-centered, considering different adverse effect profiles and patient preferences.

Re: Study: Electroshock therapy more successful for depression than ketamine

#52

Post by MonkeyMalarky »

denzilla8080 wrote: post #13
stevenalowe wrote: post #3

“The side effect profiles of the two treatments differed, with ECT more likely to cause headaches, muscle pain and memory loss, while ketamine was more likely to cause dissociative symptoms, vertigo and double vision.” I’ll take milder effects over pain and memory loss, thanks. No mention of longevity of effect, or specific studies and who paid for them.

The headaches and muscle pain are temporary. But the memory loss is severe and while not truly hindering, definitely life altering. Years are just blurred together. Some things and people just aren’t there and it’s really hard for me to remember on my own. It more changes the relationship you have with your memory.

Memories disappear in depression on their own already. Whole spans of my 20s are just gone.

Re: Study: Electroshock therapy more successful for depression than ketamine

#53

Post by joe_the_user »

denzilla8080 wrote: post #13
stevenalowe wrote: post #3

“The side effect profiles of the two treatments differed, with ECT more likely to cause headaches, muscle pain and memory loss, while ketamine was more likely to cause dissociative symptoms, vertigo and double vision.” I’ll take milder effects over pain and memory loss, thanks. No mention of longevity of effect, or specific studies and who paid for them.

The headaches and muscle pain are temporary. But the memory loss is severe and while not truly hindering, definitely life altering. Years are just blurred together. Some things and people just aren’t there and it’s really hard for me to remember on my own. It more changes the relationship you have with your memory.

While I think memory loss can vary from person to person, I know that the effective of ECT can be temporary for some people and moreover, sometimes the second just doesn't work (as happened with a friend of mine).

Re: Study: Electroshock therapy more successful for depression than ketamine

#54

Post by alasdair_ »

IIAOPSW wrote: post #32
tcj_phx wrote: post #23

My friend figured out for herself, when she was in her 30's, that she's a poor methylator who can't turn the food fortification folic acid into a usable form of Vitamin B-9. She once told me that adding L-Methylfolate to her routine was like flipping a switch from "depressed" to "not-depressed". But the doctors had already decided she was being "stabilized" by the anti-psychotic prescriptions they forced on her, so t…

Technically, its only electrocution if she dies. Otherwise its an electroshock. The consent of your friends guardian to either the former, the latter, or both is not within my ability to say.

It depends which dictionary you are reading. Many of them say things like “to injure or kill with an electric shock”

Re: Study: Electroshock therapy more successful for depression than ketamine

#55

Post by lotophage »

andy_ppp wrote: post #8

I absolutely love this talk by Sherwin Nuland, it’s beautifully told and always worth remembering that someone who seems so put together on stage can have had quite extreme troubles… electroshock therapy is surprisingly very effective in extreme cases. https://www.ted.com/talks/sherwin_nuland_how_electroshock_th...

Came to mention this! That is one of my all-time favourite TED talks. If nothing else, it's a fascinating story told well.

Re: Study: Electroshock therapy more successful for depression than ketamine

#56

Post by wnoise »

chiefalchemist wrote: post #31
rubatuga wrote: post #20

Earlier quoted context omitted.

Definitely a key factor since most psychiatrists reserve ECT for severe depression.

I think the article mentions that. That said, I would presume the Schedule 1 drugs are being approached with a conservative mindset. But they still mind have wider application once the med profession gets past the stigma. The point being, abandoning these new options should be given a fair chance even if there are intials findings like this one.

Ketamine has been schedule III since 1999.

https://www.dea.gov/sites/default/files/2020-06/Ketamine-202...

Re: Study: Electroshock therapy more successful for depression than ketamine

#57

Post by operator-name »

sibeliuss wrote: post #42
stevenalowe wrote: post #3

“The side effect profiles of the two treatments differed, with ECT more likely to cause headaches, muscle pain and memory loss, while ketamine was more likely to cause dissociative symptoms, vertigo and double vision.” I’ll take milder effects over pain and memory loss, thanks. No mention of longevity of effect, or specific studies and who paid for them.

The musician Townes Van Zandt underwent ECT and the loss of his memory haunted him his whole (very tragic) life. It's well-known how deep of an impact that had on him, and not for the better. As if the often pleasant, often interesting, often terrifying yet short term and proven harmless side-effects of Ketamine can even compare to the ECT! I would like to see how _much_ better ECT is, given all the factors. Addition…

A single data point may be a interesting, but strong evidence it does not make. Nor does speculating about a doctors caution without citations.

Ketamine in recreational use has equally documented side effects, some quite severe. Extreme circumstances that have caused irreparable damage are rare, but not unheard of.

There are also numerous other anecdotes from people that have undergone numerous session of ECT with minor side effects.

I'm not for or against ECT or ketamine, I just find the language used and conclusions reached from so little evidence extremely dangerous.

Re: Study: Electroshock therapy more successful for depression than ketamine

#58

Post by heavyset_go »

chrsig wrote: post #29
tcj_phx wrote: post #23

My friend figured out for herself, when she was in her 30's, that she's a poor methylator who can't turn the food fortification folic acid into a usable form of Vitamin B-9. She once told me that adding L-Methylfolate to her routine was like flipping a switch from "depressed" to "not-depressed". But the doctors had already decided she was being "stabilized" by the anti-psychotic prescriptions they forced on her, so t…

> But the doctors had already decided she was being "stabilized" by the anti-psychotic prescriptions they forced on her, so they just added this vitamin to their cocktail of prescriptions. Outside of very specific circumstances during hospitalization, doctors can't actually force you to take any medication.

Florida has laws on the books that let anyone go to a judge to get an order for forced treatment of someone else for mental illness or addiction. With the Marchman Act, non-compliance with treatment can have legal consequences, as well.

From here[1]:

> What happens if the respondent isn’t compliant with the treatment order?

> It’s up to the judge but the idea is that non-compliance with a court order equates to contempt of court and is punishable by jail time. This is where the “teeth” or consequences are introduced for someone refusing to comply with the treatment plan. However, we have found that many counties do not enforce treatment orders with jail time.

When the option is to be compliant with treatment or be held in contempt of court, that sounds like force.

[1] https://marchmanactflorida.com/faq/

Re: Study: Electroshock therapy more successful for depression than ketamine

#59

Post by operator-name »

augustuspolius wrote: post #21
fshbbdssbbgdd wrote: post #14

Earlier quoted context omitted.

Anecdotal reports from recreational use (higher doses than medical) are that the dissociation, vertigo, and double vision only happen while you’re high, not after it wears off.

I am also confused by this comparison. Yes, Ketamine might cause dissociation… but that’s not a side effect, that’s a catalyst for the actual expected psychological effect. It’s like saying that a side effect of drinking alcohol is feeling drunk.

> a catalyst

For better or for worse.

Re: Study: Electroshock therapy more successful for depression than ketamine

#60

Post by [deleted] »

denzilla8080 wrote: post #13
stevenalowe wrote: post #3

“The side effect profiles of the two treatments differed, with ECT more likely to cause headaches, muscle pain and memory loss, while ketamine was more likely to cause dissociative symptoms, vertigo and double vision.” I’ll take milder effects over pain and memory loss, thanks. No mention of longevity of effect, or specific studies and who paid for them.

The headaches and muscle pain are temporary. But the memory loss is severe and while not truly hindering, definitely life altering. Years are just blurred together. Some things and people just aren’t there and it’s really hard for me to remember on my own. It more changes the relationship you have with your memory.

[deleted]
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