Praise for ECT: Commentary From French Society for Biological Psychiatry and Neuropsychopharmacology

Out on PubMed, from authors in France, is this paper;

ECT: An essential therapy in psychiatry.

Sauvaget A, Bulteau S, Galvao F, Szekely D, Fossati P, Poulet E.Encephale. 2022 Aug 13:S0013-7006(22)00129-4. doi: 10.1016/j.encep.2022.05.002. Online ahead of print.PMID: 35973849

The abstract is copied below:

At a time when innovations in psychiatry are booming, particularly in the field of medical devices, we thought it necessary, as members of French Society for Biological Psychiatry and Neuropsychopharmacology (AFPBN), to reconsider one of the oldest medical devices in psychiatry: the ECT apparatus. First, we recall the regulatory aspects of ECT. National guidelines define means of implementation and conditions of administration of ECT. Second, we remind of the indications and levels of evidence of ECT in the main psychiatric disorders, including catatonia. Then, we synthetize the place of ECT alongside other brain stimulation therapies, especially repetitive Trancranial Magnetic Stimulation (rTMS). Furthermore, we explain the general effects of ECT: increased neuronal plasticity and neurogenesis, enhancement of the stress axis, resistance to oxidative stress, improved vascular endothelial function, activation of microglia and astrocytes, decrease in inflammatory events by upregulation of neuroinflammatory cytokines, and production of mitochondrial ATP. These effects appear from the first sessions and continue during the course of ECT treatment, suggesting activation of endogenous neuroprotection. Finally, we remember that most patients perform as well or better on neuropsychological assessments after ECT, relative to pre-ECT results, and this improvement continues over the following months. Memory disorders reported post-ECT are not all attributable to ECT. They may be subjective in nature or linked to residual depressive (and possibly comorbid neurogenerative) symptoms later attributed to ECT, on the basis of preexisting negative representations. We urgently need to reemphasize the crucial role of ECT in psychiatric treatment strategies as well as the need to update ECT recommendations.

Keywords: Dispositif médical; ECT; Electroconvulsive therapy; Guidelines; Medical device; Psychiatrie; Psychiatry; Recommandations; Électroconvulsivothérapie.

Here's a commentary from the French Society for Biological Psychiatry and Neuropsychopharmacology (AFPBN) that highlights the role of ECT in contemporary psychiatric practice.

Unfortunately, I am unable to get the entire article, but the lengthy abstract is helpful; hopefully a blog reader with access to the pdf will share...

Kudos to our French colleagues for this shout out to ECT.