Shock Therapy Cuts Death Risk — But the Suicide Shield Fades Fast
A meta-analysis of 17 studies with 1,182,501 people found electroconvulsive therapy (ECT) tied to a 30% lower risk of all-cause death (HR 0.70). ECT cut suicide risk by about half at 3 months (HR 0.53) but not at 1, 6, or 12 months. Effects varied by country.
Electroconvulsive therapy (ECT) is a strong treatment for severe, treatment-resistant depression. A large review now shows ECT is linked to fewer overall deaths in people with unipolar or bipolar depression.
Researchers pooled 17 studies that followed 1,182,501 people. Of these, 40,867 had ECT and 1,141,634 did not. Most patients had severe unipolar or bipolar depression.
Overall death risk was lower after ECT. The combined estimate showed a 30% drop in all-cause mortality (HR 0.70). This benefit held up at 3, 6, and 12 months of follow-up.
Suicide risk fell sharply at three months, with about a 47% reduction (HR 0.53). But that suicide protection did not hold at 1, 6, or 12 months, so the effect seems short-lived.
The size of the benefit differed by region. Japan showed the biggest drop in deaths (HR 0.17), while Denmark showed a much smaller effect (HR 0.87). Differences may come from care systems, who receives ECT, or follow-up practices.
What this means for patients and doctors is clear: ECT can be used safely for severe depression and may reduce overall death risk. However, ECT should not be seen as a long-term shield against suicide. Close follow-up, ongoing therapy, and other supports remain important.
In short, ECT is a powerful tool that can lower the chance of dying, but its protection against suicide is temporary. Patients need careful monitoring and continued care after treatment.