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I am reading and hearing that electro-shock treatment is becoming more popular for patients who suffer from schizophrenia. My son, who is 29 and suffers from schizophrenia, refuses medications and insists he would rather deal with schizophrenia than the medication's side effects. He has used several, including Thorazine, Haldol and Risperdal. None took the voices away, although they had a positive impact on his behavior from my perspective. I have become more concerned about his decision not to take medications as I see his ability to think and understand simple issues deteriorate.

My questions are: should electro-shock therapy be considered for treatment on patients with schizophrenia who may be inclined to refuse medications? Is there current research on this method of treatment specific to schizophrenia?

Orlando, Florida

Answered by E. Fuller Torrey, M.D.:
Electroconvulsive therapy (ECT) is an alternative treatment for schizophrenia and, as such, is more widely used in Europe than in the United States. Before it is used, however, individuals should be given a trial of the newer antipsychotic medications, which, for some individuals, will have fewer side effects. Modern ECT is done using unilateral electrodes over the nondominant lobe to minimize memory loss. Some memory loss may nevertheless occur and is the major side effect of the procedure. Despite Scientologist claims to the contrary, there is no evidence that ECT causes any damage to the brain. Some patients respond to as few as 12 ECT treatments, whereas others need 20 or more. Max Fink, an expert on ECT, recommended in his recent book that "a minimum course of ECT for effective relief of psychosis is one that continues for at least six months." For individuals who respond well to ECT but rapidly relapse, it is possible to use monthly maintenance treatments, and these are quite commonly used in Europe. The best source of information on ECT is the book by Dr. Fink: Electroshock: Restoring the Mind (Oxford Press, 1999).

E. Fuller Torrey, M.D.

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