Is ECT Still over the Cuckoo's Nest?

Deep brain stimulation (DBS) remains under study as a potential treatment for depression refractory to standard treatments, including electroconvulsive therapy (ECT). To understand who volunteers for brain surgery for depression, investigators reviewed data on 1098 adults with refractory major depressive disorder (MDD) or bipolar II depression who showed initial interest in a DBS study that required a previous, adequate trial of ECT. Individuals came from every state in the U.S. and several other countries and were referred by themselves (69%), family members (23%), or mental health clinicians (8%).

Only 17 individuals qualified for the study and were willing to relocate for 3 months for DBS implantation. The most common reason for exclusion…