In a large retrospective study of 3,288 patients getting ECT in Monroe County, NY, ECT recipients were found to have an increased death rate from all causes.

Babigian, H., et al 'Epidemiologic Considerations in ECT' Arch Gen Psych 1984;41:246-253

Survival in 65 patients hospitalized and treated for depression was evaluated by researchers at Brown University. They reported that the 37 patients who received ECT had survival rates of 73.0% at one year, 54.1% at two years, and 51.4% at three years. In contrast, depressed patients who did not receive ECT had survival rates of 96.4%, 90.5% and 75.0% at 1,2 and 3 years respectively.

Kroessler and Fogel, 'Electroconvulsive Therapy for Major Depression in the Oldest Old' Am J of Geriatric Psychiatry 1993;1:1:30-37

The first three years of mandated recording of death within 14 days of ECT in the state of Texas yielded reports of 21 deaths. Eleven of these were cardiovascular, including massive heart attacks and strokes, three were respiratory, and six were suicides (see section below on lack of efficacy).

Don Gilbert, Commissioner, Texas Department of Mental Health and Mental Retardation, 1996

Over twenty years ago Cotman reported in Science that ECT disrupts (protective) protein production by brain cells. More recent studies show that electric shocks to the brain also causes an increase the production of inflammatory proteins inside brain cells.

Cotman, et al 'Electroshock effects on brain protein synthesis' Science 1971;178:454-456

Marcheselli, et al 'Sustained induction of prostaglandin endoperoxidase synthase-2 by seizures in hippocampus' J Biol Chem 1996; 271:24794-24799

C. Edward Coffey, MD, a leading proponent of ECT, conducted a study at Duke University Medical Center and the Durham VA Hospital which looked at the brain scans (by MRI) of patients before and after ECT. Out of 35 patients studied, 8 had new changes on MRI after shock. That's 22%, or greater than one in 5, with anatomic brain effects. Among those with the brain changes, one patient suffered a stroke and two had new abnormal neurologic signs on exam within 6 months of the ECT.

Coffey, et al, 'Brain Anatomic Effects of ECT' Arch Gen Psych 1991;48:1013-1021

Weinberger looked at the effects of ECT on the brains of schizophrenics by comparing brain CT scans of those who had ECT with schizophrenics who never received shock. He documented that cerebral atrophy (brain shrinkage) was significantly more common in those who had ever been shocked.

Weinberger, et al, 'Structural abnormalities in the cerebral cortex of chronic schizophrenic patients' Arch Gen Psych 1979;36:935-939

Another CT scan study done by Calloway looking at a similar group confirmed that frontal lobe atrophy (brain shrinking) was significantly more common in ECT recipients.

Calloway, et al, 'ECT and cerebral atrophy: a CT study' Acta Psych Scand 1981;64:442-445

Andreasen used MRI scans to demonstrate a strong correlation between the number of previous ECT treatments to enlarged ventricles (loss of brain tissue).

Andreasen, et al 'MRI of the Brain in Schizophrenia' Arch Gen Psych 1990;47:35-41

A study in England compared the brain CT scans of 101 depressed patients who had received ECT to 52 normal volunteers. They found a significant relationship between treatment with ECT and brain atrophy. In fact ECT recipients were twice as likely to have a measurable loss of brain tissue in the front area of the brain and a tripling of the incidence of a loss of brain tissue in the back of the brain. Most significantly, the brain abnormalities correlated only with ECT, and not with age, alcohol use, gender, family history of mental illness, age at the time of psychiatric diagnosis, or severity of mental illness. (italicized words are those of the study authors)

Dolan, RJ, et al 'The cerebral appearance in depressed subjects' Psychol Med 1986;16:775-779

An animal study sought to discover whether giving supplementary oxygen during shock would prevent brain damage; they also gave vitamin E to lessen the effects of damaging 'free radical' molecules that get released during a shock seizure. They found no difference in the brain damaging effects of ECT-induced seizures by giving oxygen and vitamin E. These findings disprove the claim that modern ECT methods (complete with anesthesia and oxygen) are any less damaging to the brain than uncontrolled seizures.

Manoel, et al 'Brain damage following repeated electroshock in cats and rats' Rev Rom Neurol Psych 1986;24:59-64

ECT-induced seizures cause a rapid rise in blood pressure; at the same time the brain experiences a significant reduction in blood flow.

Webb, et al 'Cardiovascular response to unilateral ECT' Biol Psych 1990;28:758-766

Rosenberg, et al 'Effects of ECT on cerebral blood flow' Convulsive Therapy 1988;4:62-73

A Mayo clinic study of 34 elderly patients receiving shock found an 18% incidence of serious heart arrhythmias during treatment; 4 had ventricular tachycardia requiring IV lidocaine, 2 had supraventricular tachycardia requiring IV beta blockers. An additional 2 patients had other cardiogram changes.

Tomac and Rummans, 'Safety and Efficacy of Electroconvulsive Therapy in Patients Over Age 85' Am J Geriatr Psy 1997;5:126-130

Physicians from Tulane University Medical School reported on a 69 year old woman who developed brain hemorrhage during ECT. She was also left with epilepsy afterward. This was, as expected, associated with further deterioration in her mental status from her baseline depression. They conclude that the fragile vessels of the elderly may make some patients a particularly high risk for ECT.

Weisberg, etal, 'Intracerebral hemorrhage following ECT' Neurology 1991, Nov: 1849

In an analysis of 34 persons over the age of 85 who were subjected to ECT, researchers at the Mayo clinic documented that 79% suffered treatment complications, including a 32% incidence of confusion and delirium, 67% incidence of transient high blood pressure, 18% incidence of serious heart arrhythmias during treatment, 2 patients with other cardiogram changes, 3 with falls, 1 hip fracture due to fall.

Tomac, T., Rummans, T. 'Safety and Efficacy of Electroconvulsive Therapy in Patients Over Age 85' Am J Geriatr Psy 1997;5:126-130

ECT-enthusiast Dr. Coffey and his associate Dr. Figiel found that 10 out of 87 (that's 11% of) elderly patients getting ECT for depression remained delirious between ECT sessions for no discernible medical reason other than the ECT itself. (Italicized words are those of the study authors.) They documented by brain MRI scans that 90% of these unfortunate patients had lesions in the basal ganglia areas of the brain, and 90% also had moderate to severe white matter lesions.

Figiel, Coffey, et al 'Brain MRI findings in ECT-induced delirium' J of Neuropsych and Clin Sci 1990;2:53-58

In a review of the literature on the well-known ECT complication of epilepsy, researchers calculated that the age-adjusted incidence of new seizures after ECT was fivefold greater than the incidence found in the non-psychiatric population. (italicized words are those of the study authors)

Devinsky and Duchowny, 'Seizures after convulsive therapy: A retrospective case survey' Neurology 1983;33:921-5

Persistent brain wave disruption to the point of status epilepticus has been reported to occur following ECT. Individual reports by Drs. Weiner and Varma on different patients both describe acute disorientation and deterioration of intellectual function immediately following ECT. This was found to be due to ongoing epileptic brain wave forms that was initiated by the ECT.

Weiner, RD, 'Prolonged confusional states and EEG seizure activity following ECT and lithium use' Am Journal Psych 1980;137:1452-1453

and

Varma, NK et al, 'Nonconvulsive status epilepticus following ECT' Neurology 1992;42:2263-264

Publicly available data from the state of California's Department of Mental Health reveals that over 99% of ECT recipients complain of memory loss 3 months following treatment, with the average number of ECT sessions being 5 to 6.

A. Lazarow, Chief, Office of Human Rights, California Department of Mental Health, 1996

In a chapter on the cognitive effects of ECT in a psychiatry textbook, Sackheim indicates that cognitive effects (disordered thinking), particularly amnesia, can be long lasting after shock.

Sackheim, in Cognitive Disorders: Pathophysiology and Treatment, edited by Moos, et al 1992

The conclusion that amnesia can be a long lasting effect of shock is arrived at by both Squire and Weiner in separate studies.

Squire, et al 'Retrograde amnesia and bilateral ECT: Long term follow-up' Arch Gen Psych 1981;38:89-95

Weiner, et al 'Effects of stimulus parameters on cognitive side effects' Ann NY Acad Sci 1986;462:315-325

In the large NY study cited earlier, the death rates from suicide among depressed patients given ECT were slightly higher at the 1 year mark. By 5 years the suicide rate was the same for depressed patients who got ECT as those who didn't.

Babigian, H., et al, 'Epidemiologic considerations in ECT' Arch Gen Psych 1984;41:246-253

In a University of Iowa study of treatment effectiveness, 1,076 depressed patients were categorized according to whether they received ECT, or high doses of anti-depressant medications, or low doses of anti-depressant medications, or neither (ECT nor meds). Long term follow up revealed that all groups had the same suicide rates, indicating that the incidence of suicide is not affected by treatment. The authors conclude: "Therefore, active biological treatments, such as ECT, may not be deemed as 'lifesaving' now as in the past." Black, et al 'Does treatment influence mortality in depressives?' Ann Clin Psych 1989;1:165-173

The same findings are documented in three other studies: ECT does not prevent suicide in depressed patients.

Eastwood, et al 'Seasonal patterns of suicide, depression, and ECT' Br J Psych 1976;129:472-475

Babigian, et al 'Epidemiological considerations in ECT' Arch Gen Psych 1984;41:216-253

Milstien, et al 'Does ECT prevent suicide?' Convulsive Therapy 1986;2:3-6