Open up some scientific papers, and you’ll hear electroconvulsive therapy described as the most effective treatment for depression (especially very severe depression). But open up others, and you’ll see it described as completely useless—and a sad indictment on a medical establishment who’ve completely failed to provide proper evidence on it. Not only that, but they’ve exposed patients to serious side effects, like memory loss, for no good reason.

Who’s right? In this episode, we look into the most controversial psychiatric treatment since lobotomy.

NEXT WEEK: we’ll follow this with an episode on another controversial psychiatric treament: antidepressants.

On this week’s episode we discussed the article “The Perks of Being a Mole Rat”, from our sponsor, Works in Progress magazine. As ever, we’re very grateful for their support. You can find many more excellent articles at worksinprogress.co.

Show notes

* 1937 article by Egas Moniz, lobotomy Nobel Prize-winner

* Weird 1998 article defending him on the Nobel Prize website

* Megan McArdle on Walter Freeman

* The ECT scene in One Flew Over the Cuckoo’s Nest

* 2024 article discussing the possible mechanisms of ECT’s effect

* 2010 review about sham ECT studies

* 2019 review of each individual sham ECT study and the meta-analyses that include them

* 2022 response to the review

* Response to the response

* Contemporary news article about the controversy

* 2021 article in defense of ECT

* The parachute RCT

* 2010 meta-analysis on cognitive effects

* 2025 meta-analysis on autobiographical memory loss

Credits

The Science Fictions podcast is produced by Julian Mayers at Yada Yada Productions.

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit sciencefictionspod.substack.com/subscribe

Episode 96: Electroconvulsive therapy

Science Fictions