I underwent 20 sessions of outpatient ECT in 2014 and another 20 in 2015 to no avail, even with the use of ketamine as a booster to efficacy. This took place AFTER I had read "Shock: The Healing Power of Electroconvulsive Therapy" by Kitty Dukakis and Larry Tye, and I became quite friendly and familiar with the staff who administered my treatments. (I was the first patient who had actually read that book who they had treated, a book many of them had not read, and I was well respected for that and clinical research I'd previously done on ECT. Mental health unit employees can be assholes to inpatients, but my outpatient ECT OR staffers were first rate and conducted themselves like the customer service professionals who I had hired to work for me.)
Several different psychiatrists administered the procedure. Most of them were male, but a number of them were female psychiatrists. We had some excellent conversations about ECT while I was undergoing preparations.
Concerning memory loss, ALL the male and female psychiatrists told me that amnesia was a problem for female patients but NOT male patients. Three of these psychiatrists had been practicing ECT since the 1960's. (I am male, and in fact my recall was never impaired in any way.)
Females worried about memory loss should avoid this treatment option until last. (In fact, if I was female, I probably would opt for Deep Brain Stimulation if rTMS failed, if I could bypass ECT entirely in getting to DBS.) However, females more worried about weight gain who are depressed might want to consider trying rTMS and then ECT before any medications, since rTMS and ECT cannot alter metabolism the way medications do.
Going in, I was warned that the duration of my depression may well have already rendered me treatment proof, but there was a theory that ECT might not only re-sensitize serotonin receptors but ALL receptors in the brain. However, this wasn't the case with me.
Best thing for me about ECT was going under anesthesia, the fleeting high I got as I succumbed. For me there was no downside except for the fact it didn't work. ECT also made anesthesia a routine experience for me.
Vortioxetine was the next treatment failure for me after ECT, and that was the seventh of the eight classes of antidepressants I have failed on. (I have never been on a monoamine oxidase inhibitor, nor am I obligated to for qualifying to undergo psychiatrist administered euthanasia when it is legalized and implemented. I have been ruled out as a candidate for DBS, and am a weak candidate for rTMS with ECT having failed completely. I am willing to give rTMS a fair chance to fail decisively, but ECT was my final home run swing for the rafters attempt.)
Honestly, if somebody else here knows more about undergoing ECT than I do, I'd love to be made aware of that, but I did the research BEFORE undergoing ECT, so I had some context in advance. (Knowing more about undergoing ECT than me would require ECT having succeeded, in which case that person would probably not have an account here. Incidentally, patients with diseases like terminal cancer have successfully undergone ECT, and ECT has indeed been used to alleviate depression from chronic pain and fatigue.)
One other thing is critical to the success of ECT. Positive expectations that it can help is not a placebo, but clinically verified indicator of chances for success. ECT is much less likely to work if the patient is being unwillingly subjected to it. Unlike many medications, ECT doesn't work well in spite of the patient. People who attempt suicide with massive single doses of fluoxetine have instantly gotten dramatically better. (One girl in the clinical literature with OCD attempted to CTB with 50,000 mg fluoxetine had all signs of her OCD disappear completely for six months.) ECT can't eradicate symptoms like that.
Yes, I am an advocate for ECT, but ONLY for consenting patients who have additionally signed off on understanding the risk of memory loss (especially critical for any females considering this modality). No, I do NOT believe trying ECT should be a requirement before a patient is allowed to undergo psychiatrist administered euthanasia.
Legally, if you want to undergo ECT, and are a consenting adult who has read literature like "Shock" by Dukakis and Tye, then your psychiatrist is probably obligated by law to grant you a referral to undergo the procedure.
pubmed.ncbi.nlm.nih.gov
