Leonard Roy Frank
2300 Webster St., Apt. 603
San Francisco, CA 94115
January 7, 2010
To: Food and Drug
To whom it may concern:
As a survivor and opponent of electroshock (ECT, electroconvulsive treatment) who, over the years, has communicated with hundreds of other survivors of the procedure and has studied the subject and written extensively about it, I am responding to the Food and Drug Administrations call for information and comments regarding the current classification of the ECT devices. I urge the FDA not to reclassify these devices from Class III (high risk) to Class II (low risk) because the procedure continues to be, as it has been since its introduction in 1938, an extremely harmful method used on persons diagnosed as mentally ill.
Here, in summary form, is my case against ECT:
1. Electroshock is a brutal, dehumanizing, memory-destroying, intelligence-lowering, brain-damaging, brainwashing, and life-threatening technique. ECT robs people of their memories, their personality and their humanity. It reduces their capacity to lead full, meaningful lives; it crushes their spirits. Put simply, electroshock is a method for gutting the brain in order to control and punish people who fall or step out of line, and intimidate others who are on the verge of doing so.
2. Brain damage is the most ruinous effect of ECT and lies at the root of most of ECTs other harmful effects. It is also the 800-pound gorilla in the living room whose existence electroshock psychiatrists refuse to acknowledge, at least publicly. Nowhere is this more clearly illustrated than in the American Psychiatric Associations Practice of Electroconvulsive Therapy, which states that in light of the accumulated body of data dealing with structural effects of ECT, brain damage should not be included [in the ECT consent form] as a potential risk of treatment (2001, p. 102). The exclusion of brain damage as a risk of ECT makes a sham of the entire ECT informed-consent process and turns what is ostensibly a medical procedure into an act of criminal assault. The following statements and reports, all by psychiatrists or neurologists, refute the APAs position on the risk of brain damage from ECT.
3. The most immediate, obvious, and distressing effect of electroshock is amnesia. In her book Doctors of Deception: What They Dont Want You to Know About Shock Treatment, electroshock survivor Linda Andre described what that is like: The memory loss that happens with shock treatment is really memory erasure. A period of time is wiped out as if it never happened. Unlike memory loss associated with other conditions, such as Alzheimers, which come on gradually and allow patients and families to anticipate and prepare for the loss to some extent, the amnesia associated with... ECT is sudden, violent, and unexpected. Your life is essentially unlived.... You didnt just lose your suitcase; you cant say where you got it, what it looks like, what you packed in it, what trips youve taken it on. You dont know that you ever had it (Andre, 2009).
4. Electroshocks harmful effects can be long-lasting. Electroshock psychologist Harold A. Sackeim and colleagues concluded their recent study with this statement: [T]his study provides the first evidence in a large, prospective sample that adverse cognitive effects can persist for an extended period, and that they characterize routine treatment with ECT in community settings (Sackeim, 2007).
5. Electroshock causes a significant number of deaths. A 1995 report from the Texas Mental Health Department (Smith, 1995) revealed that there were eight deaths among approximately 1,600 patients (1 in 200 cases) who had undergone ECT in Texas over a then recent 15-month period, a rate 50 times higher than the death rate (about 1 in 10,000 patients) given in the consent-form sample in the American Psychiatric Associations Practice of Electroconvulsive Therapy (2001, p. 320). Reports in the professional literature give further evidence that the ECT death rate is much higher than the rate claimed by ECT proponents (Frank, 2007).
6. There are no scientifically sound studies showing that ECT is an effective method of suicide prevention. The authors of a large study published in the Annals of Clinical Psychiatry (Black, 1989) reported there was no significant difference in the suicide rate for depressed patients treated with ECT, anti-depressants, and neither of these treatments.
7. Unlike its harmful effects, electroshocks supposedly therapeutic effects are brief at best. No study shows that these effects persist for more than at most a few months following the last treatment. One study indicates the relapse rate for ECT patients is up to 50 percent within six months following treatment, even though antidepressant drugs are continued (Fink, 1999). Another study of patients diagnosed with unipolar major depression concluded that without active treatment virtually all remitted patients [i.e., patients whose symptoms diminished following ECT] relapse within 6 months of stopping ECT (Sackeim, 2001). From this, it is clear that an ECT patient with a diagnosis of depression or manic-depression runs the serious risk of becoming a permanent outpatient which usually entails ongoing drug treatment, maintenance ECT, and/or occasional inpatient stays.
8. Contrary to claims by ECT defenders, newer technique modifications have made electroshock more harmful than ever. For example, the drugs accompanying ECT to reduce certain risks, including bone fractures, raise seizure threshold so that more electrical current is required to induce the convulsion (Saltzman, 1955): the more current applied, the greater is risk of brain damage and amnesia. Moreover, whereas formerly ECT specialists tried to induce seizures with minimal current, suprathreshold amounts of electricity are commonly administered today in the belief that they are more effective.
9. Not only does the federal government stand by passively as psychiatrists continue to use electroshock, it also actively supports ECT through the licensing and funding of hospitals where the procedure is used, by covering ECT costs in its insurance programs (including Medicare), and by financing ECT research, including some of the most damaging ECT techniques ever devised. One study provides an example of such research. This ECT experiment was conducted at Wake Forest University School of Medicine/North Carolina Baptist Hospital, Winston-Salem, between 1995 and 1998. It involved the application of electric current at up to 12 times the individuals convulsive threshold on 36 depressed patients. This reckless disregard for the safety of ECT subjects was supported by grants from the National Institute of Mental Health (McCall, 2000).
10. The use of ECT is increasing. More than 100,000 Americans are being electroshocked each year; half are 60 and older, and two-thirds are women. Seventy percent of all ECT is insurance-covered. ECT specialists on average have incomes twice that of other psychiatrists. The cost for inpatient ECT ranges from $50,000 to $75,000 per series (usually 8 to 12 individual sessions). Electroshock is a multibillion-dollar-a-year industry.
11. Electroshock is especially dangerous and life-threatening for elderly patients. One Rhode Island study conducted between 1974 and 1983 divided 65 hospitalized depressed patients, 80 years and older, into two groups. Thirty-seven patients in one group were treated with ECT and the 28 in the other group were treated with antidepressant drugs. The death rate after one year for the ECT group was 7.5 times higher than that of the non-ECT group: 10 deaths among the 37 ECT patients (27%) compared with 1 death among the 28 drug-treated patients (3.6%). The authors, 2 psychiatrists, reported that two patients had only 2 ECTs: one withdrew consent, and the other developed CHF [congestive heart failure] and died before ECT could be continued. They also reported that there was lasting recovery for 22% in the ECT group and 71% in the non-ECT group. The authors attributed the poor outcomes of the ECT patients to their advanced age and physical illness (Kroessler and Fogel, 1993). In his extensive study of ECT deaths (referred to in paragraph 2C above), Impastato estimated that the ECT death rate for patients over 60 is one in 200, or 5 times greater than the death rate of 1 in 1,000 for ECT patients of all ages (1957, p. 31).
12. As a destroyer of memories and thoughts, electroshock is a direct, violent assault on these hallmarks of American liberty: freedom of conscience, freedom of belief, freedom of thought, freedom of religion, freedom of speech, freedom from assault, and freedom from cruel and unusual punishment.
Tens of thousands
of people every year in the United States are deceived or coerced into
undergoing electroshock. The FDA should do everything in its power to
discourage the use of electroshock by:
Alpers, B.J., Hughes, J. (April 1942). The Brain Changes in Electrically Induced Convulsions in the Human, Journal of Neuropathology and Experimental Neurology, pp. 172-177.
American Psychiatric Association. Electroconvulsive Therapy (Task Force Report 14). (1978). Washington, DC: Author, p. 4.
American Psychiatric Association (A Task Force Report). (2001). The Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training, and Privileging (2nd Edition). Washington, DC: Author.
Andre, L. (2009). Doctors of Deception: What They Dont Want You to Know About Shock Treatment. New Brunswick, New Jersey: Rutgers University Press, p. 2.
Black, D.W., Winokur, G. et al. (September 1989). Does Treatment Influence Mortality in Depressives?: A Follow-up of 1076 Patients with Major Affective Disorders, Annals of Clinical Psychiatry, vol. 1, no. 3, pp. 165-173.
Breggin, P.R. (1998). Electroshock: Scientific, Ethical, and Political Issues, International Journal of Risk & Safety in Medicine, vol. 11, pp. 5-40.
Cameron, D.O. (Winter-Spring 1994). ECT: Sham Statistics, the Myth of Convulsive Therapy, and the Case for Consumer Misinformation, Journal of Mind and Behavior, vol. 15, no. 1-2, pp. 177-198.
Coleman, L. (1978). Introduction to Frank, L.R. (Ed.), The History of Shock Treatment, San Francisco: Author, p. xiii.
Fink, M. (January-February, 1978). Efficacy and Safety of Induced Seizures (EST) in Man, Comprehensive Psychiatry, pp. 1-18.
Fink, M. (1999). Electroshock: Restoring the Mind, New York: Oxford University Press, p. 12.
Frank, L.R. (Ed.). (1978). The History of Shock Treatment. San Francisco: Author.
Frank, L.R. (Spring
2002). Electroshock: A Crime Against the Spirit, Ethical
Human Sciences and Services, pp. 63-71.
Frank, L.R. (2006).
The Electroshock Quotationary (an e-book).
Frank, L.R. (Ed.).
(2007). Electroshock and Death (an internet posting).
Hoch, P.H. (1948). Discussion and Concluding Remarks, Journal of Personality, vol. 17, p. 48.
Impastato, D.J. (July 1957). Prevention of Fatalities in Electroshock Therapy, Diseases of the Nervous System, p. 31. This 42-page report of 254 deaths is the largest and most detailed study of ECT deaths ever published. It is rarely cited in the writings of ECT proponents.
Kroessler, D., Fogel, B.S. (Winter 1993). Electroconvulsive Therapy for Major Depression in the Oldest Old, American Journal of Geriatric Psychiatry, pp. 30-37.
McCall, W.V., Reboussin, D.M. et al. (May 2000). Titrated Moderately Suprathreshold vs Fixed High-Dose Right Unilateral Electroconvulsive Therapy, Archives of General Psychiatry, May 2000, pp. 438-444.
Morgan, R.F. (Ed.) (1999). Electroshock: The Case Against. Mangilao, Guam: Morgan Foundation Publishers.
Polk, H.L. (August 1, 1993). Letter to the editor, New York Times.
Rymer, R. (March-April 1989). Electroshock, Hippocrates, p. 71.
Sackeim, H.A., Haskett, R.F. et al. (March 14, 2001). Continuation Pharmacotherapy in the Prevention of Relapse Following Electroconvulsive Therapy (abstract), Journal of the American Medical Association, pp. 1299-1307.
Sackeim, H.A., Prudic, J. (January 2007). The Cognitive Effects of Electroconvulsive Therapy in Community Settings, Neuropsychopharmacology, pp. 244-254.
Saltzman, C., Konikov, W. et al. (May 1955). Modification of Electroshock Therapy by Succinylcholine Chloride, Diseases of the Nervous System, p. 154.
Sament, S. (March 1983). Letter to the editor, Clinical Psychiatry News. p. 11.
Smith, M. (March 7, 1995). Eight in Texas Die after Shock Therapy in 15-Month Period, Houston Chronicle, pp. 1A, 6A.
Leonard Roy Frank, a native of Brooklyn, graduated from the Wharton School of the University of Pennsylvania in 1954. While committed to a private psychiatric facility near San Francisco in 1963, he was forced to undergo 50 insulincoma and 35 electroconvulsive procedures, which caused him severe memory loss, wiping out the preceding three-year-period and effectively destroying his high school and college educations. Following years of study reeducating himself, he became active in the psychiatric survivors movement first by becoming a staff member of Madness Network News (1972) and then co-founding Network Against Psychiatric Assault (1974), both based in San Francisco and Berkeley and opposed to all forms of coercive, fraudulent psychiatric interventions. In 1978 he edited and self-published The History of Shock Treatment. Since 1995, he has edited Influencing Minds: A Reader in Quotations (Los Angeles, Feral House), Random House Webster's Quotationary (New York, Random House, 1998), and 7 other collections of quotations for Random House. In 2006, he self-published The Electroshock Quotationary, an e-book. A resident of San Francisco since 1959, he is a member of MindFreedom International (Eugene, Oregon) and The Coalition for the Abolition of Electroshock in Texas (Austin). Here are two Internet links relevant to his work and his encounter with psychiatry: The Electroshock Quotationary: http://www.endofshock.com/102C_ECT.PDF; "The Journey of Transformation": http://www.mindfreedom.org/kb/mental-health-abuse/force/journey-of-transformation/view?searchterm=%22leonard%20roy%20frank%22
Leonard Roy Frank
International Association Against Psychiatric Assault
Spechtweg 1, 4125 Riehen, Switzerland