The adverse effects of electroconvulsive therapy beyond memory loss: an international survey of recipients and relatives

Research into the safety of electroconvulsive therapy (ECT) usually focuses on memory loss. Studies asking patients directly reveal a broader range of adverse effects. This paper reports the responses of 747 ECT recipients and 201 relatives/friends, from 37 countries, to a question about 25 possible adverse effects, in an online survey. Seventeen of the 25 were reported by more than half of both the ECT recipients and the relatives/friends. Eight were reported by more than 67% of both groups: Losing train of thought, Difficulty concentrating, Fatigue, Emotional blunting, Relationship problems, Loss of independence, Difficulty navigating and Loss of vocabulary. The first four of these were described as ‘severe’ by at least 30% of both groups. Several individual adverse effects were positively related to recipients receiving more courses of ECT and more total individual ECTs, to being female, and having bilateral electrode placements. More recent ECT was not, as often claimed, associated with fewer adverse effects. Researchers and mental health staff should pay attention to a broader range of potential adverse effects than memory loss, so as to facilitate fully informed consent, the minimization or those effects where possible, and, where not possible, referral to rehabilitation programmes.