Electroconvulsive therapy on rise in Texas

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DALLAS (AP) — Electroconvulsive therapy is on the rise in Texas, thriving as a treatment for some forms of mental illness, especially severe depression, a newspaper reported Sunday.

The Dallas Morning News (http://bit.ly/1sqjiQT ) reports that figures compiled by the state health department show a 67 percent increase since 2001 in the number of electroconvulsive therapies in the state.

The treatment, once called electroshock therapy, was used 14,176 times in Texas on 2,243 patients between Sept. 1, 2012, and Aug. 31, 2013, the last available reporting year. The state's figures do not include military and veterans' hospitals. Texas is the only state that keeps a close official count of the procedures.

Doctors who use the treatment say they do so because it's effective, and note it no longer causes patients to thrash about because they are fully anesthetized and given a muscle relaxant. They also say they have learned to fine-tune treatment, and the overall technology has improved.

But opponents say it has always caused, and continues to inflict, brain damage and long-term memory loss.

Dr. Max Fink, a New York psychiatrist who is a proponent of electroconvulsive therapy, calls it "the safest treatment in psychiatry." While Peter R. Breggin, a New York psychiatrist who thinks the treatment should be stopped, says it is "devastating to the fragile brain."

The American Psychiatric Association and the American Medical Association have recognized the procedure's effectiveness and it's covered by Medicare and many insurance plans.

In 2011, the Food and Drug Administration published a survey of medical studies on the treatment, saying the studies generally concluded that it "is probably more effective than some anti-depressants." The FDA says the studies also found that there is no evidence to suggest the treatment causes brain damage.

But the debate is hardly settled. A British study published in 2012 in Proceedings of the National Academy of Sciences found that the treatment "has lasting effects on the functional architecture of the brain." And a 2010 survey of studies, published in the European journal now called Epidemiology and Psychiatric Sciences, came down strongly against the procedure, with the authors citing brain damage, memory loss and a slightly increased risk of death.

The treatment has been employed in varying forms for 76 years. In its early days, electroshock was sometimes neither safe nor well-regulated with some patients clenching their jaws until their teeth cracked or even breaking bones. There also were abuses by practitioners, including electroshock being used on young children to stop tantrums.

Its unsavory reputation, along with the development of psychotropic medications in the 1960s and '70s helped push the treatment into the background.

Doctors who currently perform electroconvulsive therapy attribute its growing use to its success. In Texas' last reporting year, 87 percent of patients were found to have moderate, severe or extreme symptoms before the treatment. After treatment, only 19 percent of the patients were determined to have such symptoms.

Opponents note that the medical professionals who administer the treatments are the same ones who measure the results and report them to the Texas Department of State Health Services.


Information from: The Dallas Morning News, http://www.dallasnews.com

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