The discovery of electroshock therapy (ECT) | Andrew Scull and Lex Fridman

Summary by Krater

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.