BMJ  2003;327:621 (13 September), doi:10.1136/bmj.327.7415.621

Letter

Electroconvulsive therapy

Conflicting advice confuses prescribers

The first 150 words of the full text of this article appear below.

EDITOR—Carney and Geddes highlight the conflicting advice on the use of electroconvulsive therapy by two influential bodies, the National Institute for Clinical Excellence (NICE) and the Royal College of Psychiatrists.¹ The NICE guidelines restrict the use of electroconvulsive therapy while the royal college argues for wider inclusion criteria. The NICE guidelines also emphasise that no patient should be coerced into treatment.

So what is the reason for the disagreement between NICE and the royal college? NICE deliberately wants to curb the use of electroconvulsive therapy because of unresolved concerns about side effects, particularly memory loss.² Studies into its long term effects on cognitive function are lacking, but in their systematic review Rose et al say that 29-55% of patients report persistent memory loss.^{3 4} However, the validity of this figure is questionable because of the poor methodological design of the studies included.

Faced with such a lack of convincing . . . [Full text of this article]

rlevans@doctors.org.uk

Lyndon Resource Centre, Hobs Meadow, Solihull B92 8PY

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