The FDA Panel voted Friday to recommend testing of electroshock devices before their safety status might be changed. The New York Times covered the story in an article bearing the headline F.D.A. Panel Is Split on Electroshock Risks.
Comments sent to the FDA on the subject overwhelmingly favored testing.
Nearly 80 percent of 3,045 comments sent to the F.D.A. asked for stricter oversight or even a ban on electroshock treatment. It remains controversial with some advocacy groups and former patients who say it is unsafe, ineffective and causes brain damage.
The vote was as follows:
The neurological devices advisory panel to the F.D.A delivered a mixed verdict. Ten panel members favored and eight opposed classifying electroshock devices as a high risk for the treatment of severe depression, its main use. The panel favored high-risk designations for schizophrenia and three other disorders by votes of 13 to 4, 12 to 5, 14 to 3 and 16 to 1, as the advisers said there was little proof of any benefit for them.
There was one exception to this decision favoring testing and that was in the area of catatonia.
But the panel voted 9 to 8 in favor of making it easier to use electroshock for catatonia, citing a lack of other treatment.
This sidesteps the little matter of actual safety. It is certainly no safer for a person to be shocked for catatonia than it is for a person to be shocked for depression.
Dr. Peter Breggin, a New York psychiatrist, in a Huffington Post blog post, FDA Recommends Testing of ECT Machines, indicates what sort of problems may occur if this sort of loophole is permitted.
If the diagnosis of catatonia is given this loophole, we will see more and more people diagnosed with this disorder. It will be a potential medical disaster because most catatonic-like states are now caused by drug toxicity, including neuroleptic malignant syndrome from the antipsychotic drugs and serotonin syndrome from the serotonergic antidepressants. I have been a medical expert in malpractice cases in which clinicians have mistaken these toxic syndromes for psychiatric disorders, resulting in chronic disability or death from lack of proper treatment. I predict that thousands of patients who need treatment for psychiatric drug toxicity will instead end up on the shock table.
The FDA is said to generally go along with the recommendations of its panels. The panelists found in favor of testing before electroshock machines can be reclassified category II devices so they are likely to remain category III devices for some time to come. Whether the FDA will allow any kind of hypocritical category II loophole for catatonic states remains a matter for speculation.