The discovery of electroshock therapy (ECT) | Andrew Scull and Lex Fridman
A video on YouTube. In Podcasts, a Krater category.
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A discussion on the history, clinical efficacy, side effects, and controversies surrounding electroconvulsive therapy (ECT) and psilocybin research for depression.
From the video
Answers: What is the history, efficacy, and controversy of electroconvulsive therapy and modern psychiatric treatments?
- Electroconvulsive therapy history
- Modified ECT for depression
- ECT side effects and memory loss
- Treatment-resistant depression
- Schizophrenia heritability and GWAS
- Psychedelics for depression research
- Trust in science and psychiatry
What it concludes
- ECT is the only somatic therapy from the 1930s still in clinical use today.
- Modified ECT, performed under anesthesia with muscle relaxants, is one of psychiatry's most effective treatments for severe depression, with response rates of 60-80%.
- A 2025 meta-analysis found ECT may reduce mortality risk by over a third.
- ECT's best-documented side effect is autobiographical memory loss, and bilateral electrode placement causes significantly more memory loss than unilateral.
- As of 2026, esketamine (Spravato) is the only ketamine-derived drug with FDA approval for depression, showing 22.5% remission at four weeks versus 7.6% on placebo in trials.
- Genome-wide association studies (GWAS) can account for only about 30% of schizophrenia liability variance and 10% of schizophrenia cases using small variations.
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