Electroconvulsive therapy (ECT) is a controversial psychiatric treatment involving the induction of a seizure in a patient by passing electricity through the brain. While beneficial effects of electrically induced seizures
are evident and predictable in most patients, a unified mechanism of action has not yet been established and remains the subject of numerous investigations. ECT is extremely effective against severe depression, some acute psychotic states, and mania, though, like many medical procedures, it has its risks.
Since the inception of ECT in 1938, the public has held a strongly negative conception of the procedure. Initially, doctors employed unmodified ECT. Patients were rendered instantly unconscious by the electrical current, but the strength of the muscle contractions from uncontrolled motor seizures often led to compression fractures of the spine or damage to the teeth. In addition to the effect this physical trauma had on public sentiment, graphic examples of abuse documented in books and movies, such as Ken Kesey's One Flew Over the
Cuckoo's Nest, portrayed ECT as punitive, cruel, overused, and violative of patients' legal rights.
Modern ECT is virtually unrecognizable from its earlier days. The treatment is modified by the muscle relaxant succinylcholine, which renders muscle contractions virtually nonexistent. Additionally, patients are given a general anesthetic. Thus, the patient is asleep and fully unaware during the procedure, and the only
outward sign of a seizure may be the rhythmic movement of the patient's hand or foot. ECT is generally used in severely depressed patients for whom psychotherapy and medication prove ineffective. It may also be considered
when there is an imminent risk of suicide, since antidepressants often take several weeks to work effectively. Exactly how ECT exerts its effects is not known, but repeated applications affect several neurotransmitters in the brain, including serotonin, norepinephrine, and dopamine.
ECT has proven effective, but it is not without controversy. Though decades-old studies showing brain cell death have been refuted in recent research, many patients do report loss of memory for events that occurred
in the days, weeks, or months surrounding the ECT. Some patients have also reported that their short-term memories continue to be affected for months after ECT, though some doctors argue that this memory malfunction may reflect the type of amnesia that sometimes results from severe depression.
2. Which of the following is NOT cited in the passage as a current or historical
criticism of ECT?
(A) ECT causes the death of brain cells.
(B) ECT has been used to punish certain individuals.
(C) Seizures during ECT can cause bodily harm.
(D) Short-term memory loss results from ECT.
(E) Repeated applications of ECT affect several neurotransmitters in the brain.
3. Hie tone of the passage suggests that the author regards ECT with
(A) conditional support
(B) academic objectivity
(C) mild advocacy
(D) unreserved criticism
(E) increasing acceptance
are evident and predictable in most patients, a unified mechanism of action has not yet been established and remains the subject of numerous investigations. ECT is extremely effective against severe depression, some acute psychotic states, and mania, though, like many medical procedures, it has its risks.
Since the inception of ECT in 1938, the public has held a strongly negative conception of the procedure. Initially, doctors employed unmodified ECT. Patients were rendered instantly unconscious by the electrical current, but the strength of the muscle contractions from uncontrolled motor seizures often led to compression fractures of the spine or damage to the teeth. In addition to the effect this physical trauma had on public sentiment, graphic examples of abuse documented in books and movies, such as Ken Kesey's One Flew Over the
Cuckoo's Nest, portrayed ECT as punitive, cruel, overused, and violative of patients' legal rights.
Modern ECT is virtually unrecognizable from its earlier days. The treatment is modified by the muscle relaxant succinylcholine, which renders muscle contractions virtually nonexistent. Additionally, patients are given a general anesthetic. Thus, the patient is asleep and fully unaware during the procedure, and the only
outward sign of a seizure may be the rhythmic movement of the patient's hand or foot. ECT is generally used in severely depressed patients for whom psychotherapy and medication prove ineffective. It may also be considered
when there is an imminent risk of suicide, since antidepressants often take several weeks to work effectively. Exactly how ECT exerts its effects is not known, but repeated applications affect several neurotransmitters in the brain, including serotonin, norepinephrine, and dopamine.
ECT has proven effective, but it is not without controversy. Though decades-old studies showing brain cell death have been refuted in recent research, many patients do report loss of memory for events that occurred
in the days, weeks, or months surrounding the ECT. Some patients have also reported that their short-term memories continue to be affected for months after ECT, though some doctors argue that this memory malfunction may reflect the type of amnesia that sometimes results from severe depression.
2. Which of the following is NOT cited in the passage as a current or historical
criticism of ECT?
(A) ECT causes the death of brain cells.
(B) ECT has been used to punish certain individuals.
(C) Seizures during ECT can cause bodily harm.
(D) Short-term memory loss results from ECT.
(E) Repeated applications of ECT affect several neurotransmitters in the brain.
3. Hie tone of the passage suggests that the author regards ECT with
(A) conditional support
(B) academic objectivity
(C) mild advocacy
(D) unreserved criticism
(E) increasing acceptance
