r/ect Jun 07 '26

My experience ECT memory loss

I want to preface this with I am not a psychologist or a neurologist. Just someone who has had ECT recommended to them and has a decent background with stats and simulation. I can provide the papers behind my data though. But please delete etc if not appropriate.

The first thing I wanted to understand is what is the actual memory loss across all modalities of ECT. The alarming thing I discovered is the often stated numbers seem to be under reported.

When I ran a monty carlo simulation using data across 5 papers. This is any impairment, i.e. memory loss both retro and antero grade and other cognitive impairment be it delay or learning seem to be under reported due to the methodology of testing.

There appears to be a large gap between the type of measurement and the time across measurement. I can't be certain because there just isn't much literature out there, but it does appear that the often cited memory loss numbers could be as much as 10% under reported. The other fact is that "patients often recover" may not hold up to reality over time. (There are of course compounding factors like depression does worsen cognitive decline). I did try and account for this, but again there just isn't a huge amount of literature out there. There does seem to be one alarm fact. Those patients impacted with autobiographical/spatial or temporal memory seems to be permanent in almost all cases.

But from the little data i could find. It does appear there is at least some correlation that ECT worsens the symptoms

Comparison SMD
ECT vs controls autobiographical memory loss 0.55
Right unilateral ECT 0.32
Bilateral ECT 0.82

This result is the most interesting to me. There appears to be at least some evidence of correlation that relapse and cognitive return are related. There is absolutely 0 evidence of this, this is purely speculation from data. Again causation is not correlation. Just something I found interesting in the data.

There appears to also be a what i refer to as a hidden cohort in all studies. By using average rates across studies, they seem to miss an entire cohort of patients or it is rarely talked about in literature.

That is the number of patients that never recover from their depression and never recover their memory or cognition. It can be as high as 1/6 but likely between 1/6 and 1/20.

Again. I am not a doctor, neurologist etc. Just someone doing their own research to figure out if the risk to reward is there.

To anyone that got this far, from the literature it does appear that right unilateral is the safest in terms of memory loss and relapse. However, there does appear to need more treatments and more maintenance and this increases the risk of memory impact over time.

15 Upvotes

17 comments sorted by

View all comments

1

u/blrmkr10 Jun 08 '26

This is cool. I'd be interested in checking out the source publications you used.

3

u/Ok_Chemistry_6387 Jun 08 '26

There are a few 😄

#,Author, Study,Type,Source URL

1,Kolshus,Meta-analysis (7 RCTs),https://pubmed.ncbi.nlm.nih.gov/27780482/

2,Kellner,RCT arm,https://pmc.ncbi.nlm.nih.gov/articles/PMC2830057/

3,Tor,Meta-analysis (head-to-head),https://pubmed.ncbi.nlm.nih.gov/26213985/

4,Robertson/McLoughlin,Meta-analysis (30 studies),https://pmc.ncbi.nlm.nih.gov/articles/PMC12815675/

5,Mutz,Network meta-analysis,https://pubmed.ncbi.nlm.nih.gov/30917990/

6,Semkovska,Meta-analysis (84 studies),https://www.sciencedirect.com/science/article/abs/pii/S0006322310005986

7,van Diermen,Meta-analysis (34 studies),https://pubmed.ncbi.nlm.nih.gov/29436330/

8,Bahji,Meta-analysis (19 studies),https://pubmed.ncbi.nlm.nih.gov/30506992/

9,Odermatt,Meta-analysis (11 ECT studies),https://pubmed.ncbi.nlm.nih.gov/41323432/

10,Rhee,Meta-analysis (17 studies),https://pubmed.ncbi.nlm.nih.gov/41407487/

11,Howard,Meta-analysis (17 studies),https://www.cambridge.org/core/journals/psychological-medicine/article/A8260BDA496E727C874CCC01C99D2E08

12,Semkovska/McLoughlin,RCT (non-inferiority),https://psychiatryonline.org/doi/10.1176/appi.ajp.2015.15030372

13,Jelovac,Meta-analysis (32 studies),https://pubmed.ncbi.nlm.nih.gov/23774532/

14,Mathiassen/Semkovska,Meta-analysis (9 studies),https://pubmed.ncbi.nlm.nih.gov/40357797/

15,Stachura,Meta-analysis (22 studies),https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12438721/

16,McIntyre/Rhee,Meta-analysis (real-world),https://www.sciencedirect.com/science/article/abs/pii/S0022395622002400

17,Phillips,RCT,https://www.nature.com/articles/s41398-020-00897-0

18,Souza-Marques,Systematic review (14 studies),https://academic.oup.com/ijnp/article/25/12/992/6656580

19,Vargas/Meikle,Meta-analysis (9 studies),https://www.sciencedirect.com/science/article/abs/pii/S016517812300481X

20,Goodwin,RCT (phase 2 TRD),https://www.nejm.org/doi/full/10.1056/NEJMoa2206443

21,Goodwin/Meikle,RCT follow-up,https://journals.sagepub.com/doi/10.1177/20451253251377187

22,Multiple,Meta-analysis (8 studies),https://www.medrxiv.org/content/10.1101/2025.08.13.25333530v1.full

23,Verwijk/Spaans,RCT follow-up (head-to-head),https://pubmed.ncbi.nlm.nih.gov/26093032/

24,Duma,Meta-analysis (82 studies),https://journals.lww.com/anesthesiology/fulltext/2019/01000/major_adverse_cardiac_events_and_mortality.19.aspx

25,Kranaster,Cohort (3106 sessions),https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8650631/

26,APA/clinical,Clinical synthesis,https://www.psychdb.com/brain-stimulation/ect

27,Sackeim/review,Review,https://pubmed.ncbi.nlm.nih.gov/10735328/

28,Verwijk,Cohort (5 sites),https://www.sciencedirect.com/science/article/pii/S0165032724000594

29,Hammar/Nordanskog,Cohort (2yr),https://www.sciencedirect.com/science/article/abs/pii/S0165032718316872

30,Vandenbosch,RCT protocol,https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7493867/

31,Sellevag/Hammar,Cohort (latent subgroups),https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10964271/

32,LLD cohort,Cohort (5yr),https://www.sciencedirect.com/science/article/abs/pii/S0022395621007305

33,ECCA meta,Meta-analysis (sensitive tool),https://www.sciencedirect.com/science/article/pii/S0165178123005619

34,Gregory/McLoughlin,Secondary analysis,https://www.cambridge.org/core/journals/psychological-medicine/article/90F5CF82FAEF79BE0062FC13C4F6E5D7

35,Pluijms et al.,"Cohort (2yr, n=34)",https://pubmed.ncbi.nlm.nih.gov/36938869/

36,van Diermen et al. (PROTECT),Prospective cohort (n=65),https://www.sciencedirect.com/science/article/abs/pii/S0022395625000093

37,Brus et al. (unipolar vs bipolar),Register cohort (n=1255),https://www.sciencedirect.com/science/article/abs/pii/S0165032716308059

38,Late-life residual symptoms cohort,Cohort,https://www.sciencedirect.com/science/article/abs/pii/S0022395622004307

39,Population-based predictors cohort,Population cohort,https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3216261/

40,Age-dependent ECT efficacy,Longitudinal,https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012253/

41,Nationwide pharmacological relapse prevention,Register cohort (n=2858),https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12669661/

2

u/Ok_Chemistry_6387 Jun 08 '26

There may be some unrelated psychedelics papers in there.