Helen Mayberg goes to London
Professor Helen Mayberg of Emory University, Atlanta, is famed for her experiments with DBS (deep brain stimulation) on depressed people. Recently, Professor Mayberg visited London and spoke at the Science Media Centre of the Royal Insitution ("where science meets the headlines"):
"This is a very new way to think about the nature of depression.
We are not just exciting the brain, we are using electricity to retune and remodulate.
We can interrupt or switch off an abnormally functioning circuit."
She said that although DBS was still in its infancy as a treatment for depression, it was very promising.
"The effects were immediate. One patient told me she felt suddenly relieved.
These are the sickest of the sick. They are not just having a bad day."
More...
"The sickest of the sick" - I am always suspicious of psychiatrists who talk about people in such terms, or use slightly more polite and technical terms such as "intractable" "refractory" or "treatment resistant". Is this going to be another ECT: "safe and effective", but, just in case they are wrong, there is nothing to worry about because it is only used as a "last resort"? Of course, there is no restriction on the use of ECT in the sense of only using it after other treatments have been tried. In fact, the British guidelines on its use recommend that on occasion ECT may be used as a first-line treatment, more usually as a second-line treatment. So too do all the other guidelines I have seen (American, Canadian, French, Dutch for example). Psychiatrists use the stigmatising term "last resort" to marginalise ECT patients and shift responsibility for treatment from themselves to the patients.
And just how do you decide who is the "sickest of the sick" in the absence of any biological tests for mental illness?
Professor Mayberg claims that one per cent of the population might benefit from being treated with DBS for depression. In Britain that would be over half a million people with electrodes in their brain. Newspaper headlines are talking about "the sunshine implant". But would the world be a better place?
A more cautious look at DBS is taken by American neurologist Joseph H Friedman in an article he wrote last year about the comeback of psychosurgery in the form of DBS:
"...the lobotomy procedure represents a terrible, dark stain on the history of modern medicine which those of us involved in brain medicine must never forget. This "cure" for schizophrenia demonstrates what may happen when a converted few lose objectivity and a host of willing believers subvert their disbelief in the hopes that their own eyes deceived them."
Read the article here...
"This is a very new way to think about the nature of depression.
We are not just exciting the brain, we are using electricity to retune and remodulate.
We can interrupt or switch off an abnormally functioning circuit."
She said that although DBS was still in its infancy as a treatment for depression, it was very promising.
"The effects were immediate. One patient told me she felt suddenly relieved.
These are the sickest of the sick. They are not just having a bad day."
More...
"The sickest of the sick" - I am always suspicious of psychiatrists who talk about people in such terms, or use slightly more polite and technical terms such as "intractable" "refractory" or "treatment resistant". Is this going to be another ECT: "safe and effective", but, just in case they are wrong, there is nothing to worry about because it is only used as a "last resort"? Of course, there is no restriction on the use of ECT in the sense of only using it after other treatments have been tried. In fact, the British guidelines on its use recommend that on occasion ECT may be used as a first-line treatment, more usually as a second-line treatment. So too do all the other guidelines I have seen (American, Canadian, French, Dutch for example). Psychiatrists use the stigmatising term "last resort" to marginalise ECT patients and shift responsibility for treatment from themselves to the patients.
And just how do you decide who is the "sickest of the sick" in the absence of any biological tests for mental illness?
Professor Mayberg claims that one per cent of the population might benefit from being treated with DBS for depression. In Britain that would be over half a million people with electrodes in their brain. Newspaper headlines are talking about "the sunshine implant". But would the world be a better place?
A more cautious look at DBS is taken by American neurologist Joseph H Friedman in an article he wrote last year about the comeback of psychosurgery in the form of DBS:
"...the lobotomy procedure represents a terrible, dark stain on the history of modern medicine which those of us involved in brain medicine must never forget. This "cure" for schizophrenia demonstrates what may happen when a converted few lose objectivity and a host of willing believers subvert their disbelief in the hopes that their own eyes deceived them."
Read the article here...
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