Thomas A. Ban: The Ewen Cameron Story
Hector Warnes’ additional comment on Edward Shorter’s comment
I just read again Edward Shorter’s excellent and dispassionate view of Cameron’s ill- fated denouement. Shorter used a phrase that I did not like - "paralysing drugs" - (succinylcholine curare- like substance that I often used to avoid bone-fractures during the grand mal seizure produced by ECT). As you recall, we acted as anesthesiologist, emergentologist, cardiologist and psychiatrist before we co-opted each of those specialities. In all cases I used atropine before the anesthesia and O2 before and after the convulsion.
Shorter did not elaborate on the dozens of studies that did not confirm brain damage of patients given 40 or more ECTs, sometimes daily. I usually did not give more than 12 or 15 three times a week followed by an anti-depressant and/or anti-psychotic drug according to the diagnoses. We avoided giving it to older patients, particularly those with pulmonary or heart ailments. I read several articles that report ECT is still more effective that the current drugs in selective pathologies.
For a long time, we knew that chronic paranoid psychotics or chronic schizophrenia with severe negative symptoms did not respond to ECT. The most responsive were the acute bipolar disorders and the acute schizophrenic psychoses.
May 21, 2020