Adverse effects of electroconvulsive therapy on cognitive performance.

Electroconvulsive therapy (ECT) has his-torically been shown to be a highly effective method of treating major depression and catatonic state otherwise resistant to psy-chopharmacotherapy. 1-5 However, ECT has also been associated with a variety of tran-sient impairments in cognitive performance during and following the treatment. 6-10 The side effects, often subjectively reported by the patients, include deficits in orientation, short term memory function, attention, speech fluency, and executive functions lasting from hours to perhaps months in a number of cases. 6-10 These reported attrib-utes often lead to limited use of ECT as an acute treatment of treatment-resistant depression and other conditions where it can potentially produce positive overturn-ing effects. There appears to be a lack of clarity and consensus in the literature regarding ECT-related adverse effects on cognitive performance. While some studies have reported absence of any effects on memory and implicit learning, 6 several oth-ers have shown diverse negative impacts across various domains of cognition includ-ing greatest global decline associated with bitemporal ECT, major deterioration of verbal memory attributed to bifrontal ECT, and largest decline in visual memory related to right unilateral ECT, as measured by tests such as Mini Mental State exam, 7 Trail-Making, Rey visual and verbal fluency. terms