"Classics in ECT" returns today with a wonderful exchange of letters-to-the-editor in Lancet 1994-1995.
Here are the 3 letters in response (Kellett, Chatterjee and Fink) to a scurilous screed by one Tony Baker (below), asking for ECT to be banned in children.
Electroconvulsive therapy.
Fink M. Lancet. 1995 Feb 25;345(8948):519. No abstract available.
PMID: 786189
The pdf is here.
ECT and young minds.
Baker T. Lancet. 1995 Jan 7;345(8941):65. No abstract available.
PMID: 7799725
The pdf is here.
The 3 letters in response, taken together, are an eloquent defense of and explanation of the benefits of ECT.
ReplyDeleteThe below comment was sent in by Max Fink:
ECT in children
ECT in children was anathema for child psychiatrists and debates were prominent and public for many decades.
But the failure of medications to solve childrens' problems and one-by-one case reports of successful treatment in melancholic depression, mutisms, excited mania gradually changed the professional attitude. AACAP appointed a committee under chairmanship of Neera Ghaziuddin of the University of Michigan to establish ECT guidelines that encouraged ECT use. The publication in 2004 is the official position of the Academy of Adolescent and Child Psychiatry.
Practice parameter for use of electroconvulsive therapy with adolescents.
Ghaziuddin N, Kutcher SP, Knapp P, Bernet W, Arnold V, Beitchman J, Benson RS, Bukstein O, Kinlan J, McClellan J, Rue D, Shaw JA, Stock S, Kroeger Ptakowski K; Work Group on Quality Issues; AACAP.J Am Acad Child Adolesc Psychiatry. 2004 Dec;43(12):1521-39.
Max Fink
Thank you Drs Keller and Fink for highlighting this important discussion about the use of ECT in minors with severe psychiatric disorders. Interestingly, surveys of child psychiatrists towards ECT have shown that lack of practical experience is also associated with greater resistance. This is as true now as it was about 15 years ago. Better training and hands-on experience are key to acceptance of the modality! It’s an important reminder that comments about the treatment are based on science and clinical experience.
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