The effectiveness of electroconvulsive therapy: A literature review

  title={The effectiveness of electroconvulsive therapy: A literature review},
  author={John Read and Richard P. Bentall},
  journal={Epidemiology and Psychiatric Sciences},
  pages={333 - 347}
  • J. ReadR. Bentall
  • Published 1 December 2010
  • Psychology
  • Epidemiology and Psychiatric Sciences
SUMMARY Aim – To review the literature on the efficacy of electroconvulsive therapy [ECT], with a particular focus on depression, its primary target group. Methods – PsycINFO, Medline, previous reviews and meta-analyses were searched in an attempt to identify all studies comparing ECT with simulated-ECT [SECT]. Results – These placebo controlled studies show minimal support for effectiveness with either depression or ‘schizophrenia’ during the course of treatment (i.e. only for some patients… 

Is Electroconvulsive Therapy for Depression More Effective Than Placebo? A Systematic Review of Studies Since 2009

  • J. ReadC. Arnold
  • Psychology, Medicine
    Ethical Human Psychology and Psychiatry
  • 2017
There is still no evidence that ECT is more effective than placebo for depression reduction or suicide prevention, and the cost-benefit analysis for ECT remains so poor that its use cannot be scientifically, or ethically, justified.

Electroconvulsive Therapy for Depression: A Review of the Quality of ECT versus Sham ECT Trials and Meta-Analyses

The quality of most SECT–ECT studies is so poor that the meta-analyses were wrong to conclude anything about efficacy, either during or beyond the treatment period, and its use should be immediately suspended.

Electroconvulsive therapy, the placebo effect and informed consent

  • C. Blease
  • Psychology, Medicine
    Journal of Medical Ethics
  • 2012
It is contended that the process of informed consent must include comprehensive accounts of these uncertainties over the mechanism of action of ECT and given the risk of serious side effects that ECT may produce, it is concluded that a fuller description of E CT must be provided to patients and their carers.

Electroconvulsive therapy for depression : optimising treatment and exploring molecular mechanisms

High-dose right unilateral ECT should be considered as a first-line option when prescribing ECT, and post-hoc analysis indicated that there were significant changes in microRNA levels in patients with psychotic depression.

Electroconvulsive therapy effectiveness and harm

  • M. Chiesa
  • Psychology, Medicine
    The British Journal of Psychiatry
  • 2020
There is little or nothing in the literature to suggest that ECT ‘saves lives’ or that it prevents suicide, as it is often repeated, but there is some evidence through systematic reviews that E CT is not effective beyond the treatment period.

Charting the Course of Electroconvulsive Therapy: Where Have We Been and Where Are We Headed?

Evidence from multisite clinical trials in the past decade shows an evolving standard for the delivery of ECT to achieve and maintain remission and quality of life, as well as new investigational methods of delivering ECT provide a glimpse into the future of this time-tested treatment.

The Use of ECT and MST in treating depression

A systematic review of the literature on ECT (from 2009–2011) and MST (from 2001-2011) shows that MST has been used successfully in the treatment of depression, yet there is a dearth of literature in comparison with ECT.

Simulated Electroconvulsive Therapy

Objectives Agitation is the most common behavioral symptom of Alzheimer disease (AD) affecting approximately 40% to 60% of the AD population, yet there are no Food and Drug Administration–approved

Electroconvulsive Treatment: Hypotheses about Mechanisms of Action

It is hypothesized that ECT affects the brain in a similar manner as severe stress or brain trauma which activates the HPA axis and the dopamine system and may compromise frontotemporal functions.

Psychological factors related to the experience of and reaction to electroconvulsive therapy

  • P. Fisher
  • Psychology, Medicine
    Journal of mental health
  • 2012
Clinical psychologists need to be actively involved in consent procedures, use clinical formulation to understand the perspective of patients, and empower patients to share their views of ECT with mental health professionals and service developers.



A Meta-Analysis of Electroconvulsive Therapy Efficacy in Depression

Some evidence was found that psychosis predicted better response to ECT, and ECT was shown to be superior to medication and simulated ECT.

Electroconvulsive therapy for schizophrenia.

Limited evidence suggests that ECT combined with antipsychotic drugs results in greater improvement in mental state than with antippsychotics alone, and there is no evidence that this early advantage for ECT is maintained over the medium to long term.

Sham electroconvulsive therapy studies in depressive illness: a review of the literature and consideration of the placebo phenomenon in electroconvulsive therapy practice.

The sham ECT literature is reviewed in detail, and the author discusses possible mechanisms by which sham-treated patients improved, and some information regarding ECT response of depressive subtypes that informs the modern ECT practitioner.

Patients' perspectives on electroconvulsive therapy: systematic review

The current statement for patients from the Royal College of Psychiatrists that over 80% of patients are satisfied with electroconvulsive therapy and that memory loss is not clinically important is unfounded.

The Cognitive Effects of Electroconvulsive Therapy in Community Settings

A prospective, naturalistic, longitudinal study of clinical and cognitive outcomes in patients with major depression treated at seven facilities in the New York City metropolitan area.

Combined Use of Electroconvulsive Therapy and Antipsychotics in Schizophrenia: the Indian Evidence. A Review and a Meta-analysis

The evidence was not conclusive because of several methodological difficulties, but it does suggest that further research is required to determine the usefulness of the ECT-antipsychotic combination in the acute treatment of schizophrenia.


Effect of ECT on mortality and clinical outcome in geriatric unipolar depression.

Patients who received ECT were more likely to exhibit psychomotor retardation and to have had prior courses of ECT than those who did not receive ECT and to demonstrate greater clinical improvement than those treated only with pharmacotherapy.

[The efficacy of ECT treatment in depression: a meta-analysis].

ECT treatment is an efficient tool in the short-term treatment of depression, and its effect is superior to antidepressant drug treatment and thus its use may be advantageous in patients suffering from severe depression with elevated suicidal risk.