Resistant Depression: "Electroshocks are effective and yet underused"

The use of electroshocks to treat resistant depression is debated in patients, their families and doctors. Professor Pierre-Michel Llorca, head of department in psychiatry at Clermont-Ferrand University Hospital, gives us his position on the subject.

"Should we stop using electroconvulsive therapy (or electroconvulsive therapy, NDLR)?" ask experts in the British Medical Journal. "No," Professor Pierre-Michel Llorca, head of the department of psychiatry at the University Hospital of Clermont-Ferrand, answers very clearly.
Why Doctor: what do you think of the different arguments raised during the debate transcribed by the BJM?

Pierre-Michel Llorca: I find that the party's arguments in favor of stopping electroshock are extremely specious and incomplete. They do not reflect the scientific reality or what is currently done in practice. For me, electroshock is an effective curative strategy that remains underutilized.
How is electroconvulsive therapy practiced today?
Pierre-Michel Llorca: in the collective imagination, we still have the images conveyed by the film Flight over a cuckoo's nest, where electroshocks are performed without anesthesia, in an extremely barbaric way. Today, this is done under very short-term anesthesia, accompanied by a curarization, which rules out any risk of fracture and pain when provoking the seizure. In 1995, a circular formally supervised electroconvulsive therapy and its various protocols.
Do electroconvulsive effects have adverse effects?
Pierre-Michel Llorca: yes, like a lot of drugs. It is possible in particular to have memory loss, but they do not concern all the patients, are reversible and of short duration in the majority of the cases. This treatment does not cause "brain losses", contrary to what some experts argue in the BJM.

What are the benefits of electroconvulsive therapy?

Pierre-Michel Llorca: the great advantage is that electroconvulsive therapy can work on depressed people on whom conventional drugs have no effect. In addition, they act quickly. Patients treated with electroconvulsive therapy can be seen emerging within a week, where antidepressants take two to three weeks to take effect. Moreover, when patients relapse, in general it is they who ask for an electroconvulsive therapy.

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