Rating Feedback for Dr. Goodman (1289224)
'ECT helps pull you out of depression however, Dr. Goodman may continue to give way, way, way too many treatments. One should receive between 6-12 treatments and he gave me 63. I began complaining at every treatment that my memory was continuing to get worse but he would just pat my hand and tell me not to worry. I trusted him and now I've lost huge chunks of my long term memory and am still working hard to recover my short-term memory. ECT can be good, Dr. Goodman can be bad. Just be careful.'
I am Dr. Goodman,the MD who treated this patient, and I am very upset about the unsatisfactory outcome of treatment.
I cannot discuss the details of this specific situation, since the operators of this website have access to this patient's identity, so I cannot reveal protected medical information. However, I can speak in general about ECT and about how a situation such as that described above can occur. First, this person is correct that patients receive usually between 6-12 treatments, but this is for the initial series of treatments only. In the modern practice of ECT, additional treatments are almost always done to protect the gains made from a successful initial series of ECT. Otherwise relapses occur 80-90% of the time. These treatments are spread out over time as we attempt to find medication that will help the patient remain well, allowing us to then stop ECT treatment altogether. Sometimes, as the time between treatments are extended, patients start to relapse and require additional series of close together treatments. These relapses occur for many reasons, though fortunately, they occur only in a small percentage of patients. When someone has 63 treatments, it indicates that many relapses occurred, requiring several series of close together treatments. In this situation, especially if the patient is begining to have memory problems, one is faced with the dilemma of deciding which is worse-letting the depression return, or contributing further to memory problems by doing additional treatments. In contrast to the comment above, this is an ongoing discussion I have with patients in this situation. These patients come to ECT in the first place because nothing else has been of help for their depression-they are often desperate and suicidal. Some patients, with the help of these discussions, choose to stop ECT. Most decide to continue treatment despite the memory problems because of their desperation. However, this is always a decision made by the patient in collaboration with me, and not a decision I take lightly. Because of California law, every single ECT treatment that I perform is reviewed by a committee of MDs at the hospital where it is done to insure that the treatment was needed and appropriate, and this committee has never found that my treatments have been either inappropriate or excessive. Fortunately, most patients never experience the problem that occured with this individual because they get better with treatment, and then remain better due to our protocol of slowly stretching out the interval between treatments over time. None the less, loss of some memory can be a problem with ECT, and we are actively addressing the problem: We have just received funding for a study that will attempt to minimize memory problems with ECT by using MRI scans before treatment begins to inform us exactly where on the head the treatment electrodes should be placed given the anatomy of the head of that individual. Hopefully, if this research is successful, we will be able to further minimize the adverse side effects of ECT, making it an even better treatment for those severly depressed patients in whom nothing else has helpful in alleviating their pain.