Do the Seizures from ECT Do Anything Therapeutic at All?

     How did anybody come up with the idea that causing a person to have grand mal seizure would help cure them of schizophrenia? Sounds kind of crazy, doesn’t it? 

     It might be.
 
     Hungarian psychiatrist Ladislas Meduna was the first to give it a shot. He had observed from post mortem autopsies that patients diagnosed with schizophrenia had far fewer glia cells in their brains than patients with epilepsy did. Glia cells provide nutrients to neuron cells, but they do not produce electrical impulses, as neuron cells do.

     Most “normal” people have equal amounts of glia and neuron cells in their brains, about 85 billion of each.

     Meduna decided that causing seizures in schizophrenic patients might increase the number of glia cells they had in their brains, just because they’d had a seizure. That might help cure their schizophrenia, he thought. Meduna had been led to this hypothesis after studying some of the research of fellow Hungarian psychiatrist Gyula Nyiro, who in 1929 had discovered that epileptic patients who had developed symptoms of schizophrenia had fewer epileptic seizures than non-epileptic schizophrenics.

     Nyiro, however, had wanted to cure epilepsy with schizophrenia, not the opposite. He started injecting blood from patients with schizophrenia into patients with epilepsy, but he had such poor results, he gave up with that hypothesis.

     Perhaps Meduna had missed that part of Nyioro’s research.

     Meduna started experimenting with ways to induce seizures in animals and he settled on high giving doses of camphor for his first human experiments. About two grams of camphor causes a convulsion. Four grams is considered fatal. He found his first schizophrenic subjects in a psychiatric hospital outside of Budapest where no one would question his experiments.

     Soon he switched from camphor to Metrazol for triggering seizures because it caused the grand mal seizures much more quickly. He did not like using electric shock, which was quicker yet, to prompt a seizure, though, because of the amnesia it caused. He had a fifty/fifty success/failure rate with Metrazol per his published findings.

     He and some of his fellow physicians began to speculate, though, that the intense fear that patients felt prior to the pain they experienced from the Metrazol could itself have been part of the reason that his treatments were successful on fifty percent of his patients. They had actually only been frightened into their very temporary sanity.

     When Italian psychiatrist Ugo Cerletti published his work from 1938 on inducing seizures with electric shock to “treat” schizophrenia, ECT became the preferred psychiatric method because of its ease of application. Cerletti was actually nominated for a Nobel Prize for his electroshock therapy and it has been psychiatry’s standard method to cause grand mal seizures ever since.

     But does it have any permanent, positive effect?

     A 2013 study showed that that only about 50 percent of ECT patents did not relapse within a year after their first treatment, but that was only if they were being prescribed antidepressants afterward. 37 percent of those actually relapsed within the first six months. For those who did not take any antidepressants after ECT, the number of relapses doubled.

     A more recent 2022 study showed that when ECT treatments are stopped abruptly, and no  antidepressants are administered, there is an 84 percent relapse rate.

     Perhaps Meduna and his fellow physicians had been right. The intense fear patients experience prior to a  Metrazol or an electroshock treatment is itself enough to briefly snap a person out of their mental disorder.

     But, at best, only temporarily.