Psychiatric Hospitals Fail to Warn Electroshock Patients of FDA-Cited Risks, CCHR Review Finds

The Citizens Commission on Human Rights (CCHR) International has released a review of more than 50 psychiatric hospitals across 23 states that administer electroconvulsive therapy (ECT), finding that none have updated their websites to reflect adverse effects the U.S. Food and Drug Administration (FDA) required for mitigating risks in 2018. The review alleges that tens of thousands of Americans, including children, are not being warned about long-term memory loss and potential brain damage, warranting a government investigation and review of the need to ban ECT devices.

Thousands opposed the FDA's 2018 reclassification of ECT devices from high-risk Class III to lower-risk Class II for limited uses. The FDA's final rule justified the change partly by requiring patient labeling to warn that "[t]he long-term safety and effectiveness of ECT treatment has not been demonstrated" and recommending formal neuropsychological assessments before and during treatment to monitor cognitive damage. According to CCHR, none of the facilities report this information. The review also shows the hospitals failed to warn of permanent memory loss (88% of hospitals), cardiovascular problems (69%), and the right to refuse consent (88%).

Federal agencies bear much of ECT's costs, even though psychiatrists admit it cannot cure and often requires ongoing maintenance treatments. A private insurance analysis found ECT patients hospitalized 4 to 29 days longer than those receiving standard treatment, with additional healthcare costs of $5,700 to $52,700. Psychiatrists who practice ECT often earn roughly twice the salary of other psychiatrists. ECT is estimated to be a $5.05 – $7.6 billion-a-year industry.

ECT delivers up to 460 volts of electricity through the brain to induce a grand mal seizure. Devices were grandfathered in 1976 without premarket approval or clinical trials proving safety and efficacy. The FDA's 2018 Final Rule specified there is no clinical data supporting safety and efficacy for schizophrenia, schizoaffective disorder, or mania (which remain Class III). Despite this, 71% of the hospitals promote ECT for schizophrenia/schizoaffective disorders—including the Department of Veterans Affairs—and 35% promote it for mania. The FDA lists mania and worsening psychiatric symptoms as adverse effects. Some also promote it off-label for autism, Alzheimer's, Parkinson's, and dementia, despite ECT's known memory loss effects.

Many hospital claims are misleading and unsubstantiated, including comparing ECT to jump-starting a car battery (a jump start uses 12 to 14 volts, while ECT uses more than 30 times that), stating ECT "turns the brain on and off just like a computer," or that ECT is "no worse than going to the dentist." The need for full informed consent regarding ECT has been upheld in courts, especially with a warning about potential brain damage. Expert testimony before the Nebraska Supreme Court concluded that "ECT causes persistent or permanent memory loss and brain damage in a substantial proportion of recipients—somewhere between 12% and 55%." Neuropathologists equate ECT's effects to traumatic brain injury, with victims suffering permanent cognitive impairment.

The FDA erroneously believed that involuntary ECT is uncommon and always requires a judicial proceeding. In reality, state laws vary widely: six states have no ECT laws; many jurisdictions lack provisions for judicial oversight. Only seven states require a court order for ECT on minors; 12 have no regulations for children. Texas and California ban ECT on minors, due to CCHR's actions.

Jan Eastgate, President of CCHR International, received ECT in 1975 after a misdiagnosis of hyperthyroidism as depression. She said, "After antidepressants worsened my condition, I was told I needed ECT, that it was the same as jump-starting the heart, and there were no major side effects. It was a lie." Psychiatrist Niall McLaren advises patients that any psychiatrist who tells them "'You need ECT' is really only saying, 'I don't know what else to do.'" He is adamant: "No psychiatrist needs to use ECT." CCHR, established in 1969 by the Church of Scientology and Dr. Thomas Szasz, calls for individuals damaged by ECT to report the abuse to it and encourages families and doctors to watch its documentary, Electroshock: Therapy or Torture.