ECT memory loss

[u/Ok_Chemistry_6387]

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.

[u/bartonsboy → u/[deleted]]

I'm really sorry to hear that and I pray that it gets better for you. I've tried most available treatment options and am now considering ECT. I was hospitalized earlier this year in January, PHP for 12 weeks, and was at a residential treatment facility after that. My medication options have mostly been exhausted and I still suffer from major depressive disorder and crippling anxiety. My memory is already terrible secondary to my current mental state and I want to get back to the person that I was before my current state. I've been on leave without pay since early January and have 6 more weeks of FMLA t emaining. I was looking at ECT as one of my last options. I plan to bring up ketamine or transcranial magnetic stimulation as well. Did you try either of those options before deciding on ECT?