As a medical journalist who published several articles criticising the overuse of electroconvulsive therapy (ECT) and even questioned its superiority to sham ECT, I protest at your reference to “the hell of electroconvulsive therapy” (‘We exist upon the fringe of the world’: the queer American poets who battled madness and obscurity, 3 July). First, by the 1960s, ECT was usually done under general anaesthesia. As a trainee psychiatrist, I regularly administered both anaesthesia and ECT. Second, even without pre-ECT anaesthesia, any epileptic will confirm that a significant period of complete retrograde amnesia always accompanies a convulsion. No ECT patient recalls an electric shock and ECT was a humane improvement on the drug-induced convulsions of its original form. When antidepressant drugs fail, many patients improve after placebo ECT (anaesthesia only), but real ECT is significantly – though not vastly – superior. You should not needlessly deter severely depressed patients from accepting it.
Colin Brewer
London
