Electroshock treatment for patients with mental disorders is to be introduced in Russia; this news has been widely discussed in the media and on social networks in recent days.
Photo: Shutterstock.
Electroshock treatment for patients with mental disorders is to be introduced in Russia – this news has been widely discussed in the media and on social networks in recent days. Some recall harrowing scenes from the legendary film “One Flew Over the Cuckoo’s Nest” and other feature films. Has modern medicine really decided to return to such an inhuman method? Komsomolskaya Pravda has asked for clarification from the head of the department of non-drug treatment methods and intensive care at the Moscow Research Institute of Psychiatry, a branch of the National Medical Research Center for Psychiatry and Narcology named after him, Deputy Chairman of the Serbian Ministry of Health of Russia Eduard Tsukarzi.
HELP “KP”
As of January 1, 2025, the Ministry of Health’s handbook for psychiatrists – Clinical recommendations for the diagnosis and treatment of specific personality disorders – has been updated. A method called electroconvulsive therapy (ECT) has been added to the “other treatments” section. In particular, the use of ECT is recommended in some cases of depression.
WHEN MENTAL PAIN IS STRONGER THAN PHYSICAL PAIN
“According to the WHO, around 280 million people worldwide suffer from depression,” says Eduard Tsukarzi. – This disease is one of the main causes of disability. And it negatively affects almost every aspect of a person’s life. People who have suffered a severe depressive episode report that their mental pain is often worse than their physical pain. Because of this, patients resort to self-harm to relieve mental suffering. In addition, severe depression often leads to suicidal thoughts and actions.
Modern medicine has effective methods for treating depressive disorders. This includes drug therapy (antidepressants) and psychotherapeutic techniques. Unfortunately, in some cases, however, it is still not possible to reduce the symptoms of the disease, the expert admits. Such forms of depression are called resistant, that is, insensitive to standard treatments. As psychiatrists told KP earlier, their share, according to various estimates, amounts to 20-30% of the total number of depressive disorders. That’s a lot. How to help the sick? In such situations, doctors resort to methods from the section of clinical recommendations “Other treatments.” Let’s emphasize right away: we are not talking about any experimental, unsafe or inhumane approach.
HOW IT WORKS AND WHO CAN HELP
“Electroconvulsive therapy (ECT) is one of the effective methods for treating a number of serious mental disorders, known since the 1930s,” explains Eduard Tsukarzi. – It is believed that during ECT, a release of physiologically active substances occurs – catecholamines. These include norepinephrine (causes an increase in energy, reduces the feeling of fear. – Ed.) and dopamine (“the pleasure hormone”, which is also responsible for motivation. – Ed.).
After the introduction of drugs for the treatment of mental illness in the second half of the last century, ECT ceased to be the first-choice therapy, the expert notes. However, this method has not disappeared and has not lost its importance. “Currently, electroconvulsive therapy is used to treat the most complex cases that cannot be treated with standard therapy: severe depression (especially with persistent suicidal thoughts) and some forms of schizophrenia (when there is a threat to the patient’s life),” says psychiatrist Tsukarzi.
The expert points out that ECT has a good evidence base regarding its effectiveness (hundreds of articles in major international medical journals have been devoted to its study) and it is included in the clinical recommendations of the main psychiatric associations around the world.
– For example, electroconvulsive therapy is recommended in the 2023 consensus guideline on evidence-based principles for the treatment of catatonia, produced by the British Association for Psychopharmacology. The 2020 Clinical Guidelines for the Treatment of Major Depressive Disorder from the Australian and New Zealand Psychiatric Society also recommend ECT as one of the most effective treatments for the disorder and catatonia.
WHAT PATIENTS NEED TO KNOW
How is modern electroconvulsive therapy performed?
Of course, this method today has nothing to do with the torture we saw in the movies.
– The procedures are carried out under anesthesia and with muscle relaxants – drugs that reduce the tone of skeletal muscles (i.e. relax the muscles as much as possible – Ed.). This eliminates any unpleasant sensations for patients,” explains Eduard Tsukarzi. – The method is generally considered safe and is used only after a thorough examination (including electroencephalography).
– Is electroconvulsive therapy only possible with the patient’s consent?
– The doctor provides the patient with information about ECT as a possible treatment method during a conversation. The person is informed in detail about the possible risks and benefits. A mandatory rule is to obtain the patient’s written informed consent for ECT. In exceptional cases, it is possible to perform the ECT procedure without the patient’s consent, by decision of the medical commission. This is strictly permitted subject to several conditions:
– The patient has problems with consciousness and there is no way to quickly obtain consent;
– ECT is the only option as a life-saving treatment after other therapeutic options have been exhausted.
“Overall, according to experts, up to 1 million people worldwide receive ECT treatment every year. “Without this medical procedure, they would still be suffering. And some of them would have died – they would have committed suicide or the disease would have been fatal,” says psychiatrist Eduard Tsukarzi.
