Reevaluating the Benefits and Risks of Electroconvulsive Therapy: Are Promises Overstated?

Recent findings suggest that the advantages of electroconvulsive therapy (ECT) may be overstated, while its associated risks are often underestimated. A comprehensive survey published in the Journal of Medical Ethics examined what patients and their families recall being told about ECT before undergoing the procedure. Results indicated that individuals are nearly four times more likely to remember being told that memory issues from ECT are temporary rather than permanent, and six times more likely to recall being assured that ECT can be life-saving, over potential heart complications.

ECT is a procedure where controlled seizures are induced in the brain via electrical currents, typically involving six to twelve sessions under anesthesia over several weeks. Despite its long history since 1938, ECT remains controversial in the mental health community, with ongoing debates about its mechanisms, appropriate use cases, and safety profile. A 2023 joint report by WHO and UN emphasized that patients should be thoroughly informed of all risks, including memory loss and potential brain damage.

However, analyses of patient information leaflets from Australia and the UK reveal a pattern of exaggerating the treatment's efficacy while downplaying significant risks. The survey data, collected from 858 ECT recipients and 286 relatives across 44 countries, highlighted that many patients were inadequately informed or misinformed about the true nature of ECT's effects.

Most respondents were white women, with an average age of 41 at their last treatment, primarily conducted between 2010 and 2024. The primary reasons for undergoing ECT included severe depression, psychosis, bipolar disorder, and catatonia. When asked about the information they received, many recalled being told that memory problems would only be temporary, while few were informed about long-term risks such as persistent memory loss or heart issues.

Furthermore, many respondents were influenced by misinformation, including the misconception that depression results solely from chemical imbalances and that ECT is the most effective solution. The survey found that over half of the patients believed they were not given sufficient information before treatment and were often presented with overly optimistic views about ECT's safety and effectiveness.

These findings align with prior research indicating that risk minimization and misinformation are common, raising legal and ethical concerns about informed consent. The authors call for improved transparency and balanced communication from healthcare providers and urge regulatory bodies to intervene if necessary to uphold ethical standards. Ultimately, ensuring patients and their families are well-informed is vital, given the complex balance of benefits and risks associated with ECT.

source: https://medicalxpress.com/news/2025-08-medical-pros-electroconvulsive-therapy-exaggerated.html