Letter: Benefits and drawbacks of electric shock therapy

Sir: I must disagree with Lucy Johnstone's assertion (letter, 14 December) that electroconvulsive therapy (ECT) lacks a rationale for its use and convincing evidence for its efficacy. This blanket statement does not hold water.

Over the last 16 years an impressive body of evidence has accrued that ECT has well-defined, although complex, effects upon brain function, which are very similar to those of anti-depressant drugs, and which do indeed provide a reasonable rationale for its use in the treatment of patients with severe depression.

Its efficacy has been shown by numerous carefully conducted clinical studies in depressive illness, and detailed guidelines for its use in this condition have been published by the Royal College of Psychiatrists. When used properly, ECT can bring relief to seriously depressed patients.

Future research into the biological nature of mental illness and its treatment may clarify further how ECT brings about the changes in brain function through which it is thought to produce its therapeutic effects, and allow the development of treatments lacking the adverse effects of ECT.

Yours sincerely,

D. G. GRAHAME-SMITH

Rhodes Professor of

Clinical Pharmacology

Radcliffe Infirmary

Oxford

14 December

The writer is honorary director of the Medical Research Council Unit of Clinical Pharmacology.