Electroconvulsive therapy
A treatment that passes an electric current through the head to bring on a convulsion. Begun in Rome in 1938 by Ugo Cerletti and colleagues; today it is given under anaesthesia and used for severe depression.
In 1934 the Hungarian psychiatrist Ladislas Meduna began bringing on convulsions with drugs in patients with schizophrenia, on the idea that epilepsy and schizophrenia oppose each other[1]. Ugo Cerletti in Rome thought of using electricity instead. Working with pigs, he found a wide gap between the current that causes a convulsion and the current that kills, and in 1938 he tried it on the first patient[2].
Begun for schizophrenia, the treatment soon came to be used for severe depression. A 2003 review of six trials (256 patients in all) that compared real treatment with a sham in which everything, including the anaesthetic, was the same except the current concluded that symptoms of depression eased clearly more with the real treatment, and that it is effective in the short term[3].
Related terms
- SchizophreniaAn illness in which the connections between mental functions such as thought and feeling break down. The word was coined in 1908 by the Swiss psychiatrist Eugen Bleuler.
- Insulin coma therapyA treatment for schizophrenia in which large doses of insulin put the patient into a coma. Reported by Manfred Sakel in 1933 and widely adopted, but a controlled trial in 1957 found no effect of the insulin itself.
Sources
- M. Fink, “Meduna and the Origins of Convulsive Therapy,” American Journal of Psychiatry 141(9), 1034–1041 (1984).
- D. J. Impastato, “The Story of the First Electroshock Treatment,” American Journal of Psychiatry 116(12), 1113–1114 (1960).
- The UK ECT Review Group, “Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis,” The Lancet 361(9360), 799–808 (2003).