{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T02:05:18Z","timestamp":1777860318151,"version":"3.51.4"},"reference-count":81,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Risk &amp; Safety in Medicine"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>This patient commentary addresses the absence of rigorous placebo- or sham-controlled trials for electroconvulsive therapy (ECT) and discusses whether its therapeutic effects are partly attributable to non-seizure components like anesthesia and subthreshold electrical stimulation. It proposes noninferiority trials comparing ECT and non-ictal treatments such as subconvulsive electrotherapies and psychotherapeutic anesthesia to investigate these components and evaluate potential alternatives with lesser adverse effects.<\/jats:p>","DOI":"10.1177\/09246479251377340","type":"journal-article","created":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T04:56:14Z","timestamp":1757134574000},"page":"9-13","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Patient viewpoint: The case for exploring non-seizure alternatives to ECT"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8550-5969","authenticated-orcid":false,"given":"Christopher James","family":"Dubey","sequence":"first","affiliation":[{"name":"Patient, Activist, and Independent Scholar, Newington, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"e_1_3_5_2_2","article-title":"ECT \u2013 an American\u2019s odyssey","author":"Dubey C","year":"2018","unstructured":"Dubey C. ECT \u2013 an American\u2019s odyssey. Ment Health Today 2018. https:\/\/www.mentalhealthtoday.co.uk\/blog\/in-our-right-mind\/ect-an-american-s-odyssey (accessed 21 August 2023).","journal-title":"Ment Health Today"},{"key":"e_1_3_5_3_2","article-title":"Upcoming ECT legislation needs to be revised","author":"Dubey CJ","year":"2025","unstructured":"Dubey CJ. Upcoming ECT legislation needs to be revised. Mad In America 2025. https:\/\/www.madinamerica.com\/2025\/02\/ect-legislation\/ (accessed 11 April 2025).","journal-title":"Mad In America"},{"key":"e_1_3_5_4_2","unstructured":"Human Rights Watch. Treated worse than animals: abuses against women and girls with psychosocial or intellectual disabilities in institutions in India. https:\/\/www.hrw.org\/report\/2014\/12\/03\/treated-worse-animals\/abuses-against-women-and-girls-psychosocial-or-intellectual (accessed 3 December 2014)."},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.2866"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291721005031"},{"key":"e_1_3_5_7_2","first-page":"104973232413033","article-title":"Long-term adverse effects after electroconvulsive therapy (ECT): a narrative analysis exploring people\u2019s experiences, meaning-making, and coping","volume":"35","author":"Shipwright E","year":"2024","unstructured":"Shipwright E, Murphy D. Long-term adverse effects after electroconvulsive therapy (ECT): a narrative analysis exploring people\u2019s experiences, meaning-making, and coping. Qual Health Res 2024; 35: 10497323241303391.","journal-title":"Qual Health Res"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-017-0819-5"},{"key":"e_1_3_5_9_2","doi-asserted-by":"crossref","unstructured":"Oliphant RYK Smith EM Sharma AN. Chapter 9 - electroconvulsive therapy in children and adolescents. In: Ferrier IN Waite J (eds). The ECT Handbook. Cambridge University Press pp. 67\u201373.","DOI":"10.1017\/9781911623175.009"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1017\/S2045796021000846"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1891\/EHPP-D-19-00014"},{"key":"e_1_3_5_12_2","first-page":"k5233","article-title":"Rapid response: electroconvulsive therapy for people with schizophrenia: updating a Cochrane systematic review for two decades","volume":"364","author":"Shokraneh F","year":"2019","unstructured":"Shokraneh F, Sinclair D, Irving CB, et al. Rapid response: electroconvulsive therapy for people with schizophrenia: updating a Cochrane systematic review for two decades. Br Med J 2019; 364: k5233. https:\/\/www.bmj.com\/content\/364\/bmj.k5233\/rr-8","journal-title":"Br Med J"},{"issue":"3","key":"e_1_3_5_13_2","first-page":"847","article-title":"Electroconvulsive therapy for treatment resistant schizophrenia","volume":"3","author":"Sinclair DJ","year":"2019","unstructured":"Sinclair DJ, Zhao S, Qi F, et al. Electroconvulsive therapy for treatment resistant schizophrenia. Cochrane Database Syst Rev 2019; 3(3): 847.","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"e_1_3_5_14_2","first-page":"593","article-title":"Electroconvulsive therapy for the depressed elderly","volume":"2003","author":"Stek ML","year":"2003","unstructured":"Stek ML, Der FV, Hoogendijk WJG, et al. Electroconvulsive therapy for the depressed elderly. Cochrane Database Syst Rev 2003; 2003(2): 593.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/02698811231158232"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.21lr14047"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.21f13992"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1192\/bja.2021.25"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.2381"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/HRP.0000000000000365"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2013.00094"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0000000000000143"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/070674371105600104"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2023.0728"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41386-023-01677-2"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0000000000000121"},{"key":"e_1_3_5_27_2","article-title":"Electroconvulsive therapy for depression","author":"Munkholm K","year":"2021","unstructured":"Munkholm K, J\u00f8rgensen KJ, Paludan-M\u00fcller AS. Electroconvulsive therapy for depression. Cochrane Database Syst Rev 2021. https:\/\/doi.org\/10.1002\/14651858.cd013843","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"e_1_3_5_28_2","first-page":"CD015164","article-title":"Electroconvulsive therapy for preventing relapse and recurrence in people with depression","volume":"2022","author":"Munkholm K","year":"2022","unstructured":"Munkholm K, J\u00f8rgensen KJ, Paludan-M\u00fcller AS. Electroconvulsive therapy for preventing relapse and recurrence in people with depression. Cochrane Database Syst Rev 2022; 2022(1): CD015164.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291712001717"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(20)30036-5"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1017\/gmh.2023.26"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e3181719b23"},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700031937"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1986.tb51235.x"},{"key":"e_1_3_5_35_2","first-page":"4","article-title":"ECT: an effective and safe treatment","volume":"38","author":"Henry ME","year":"2021","unstructured":"Henry ME. ECT: an effective and safe treatment. Psychiatr Times 2021; 38: 4\u20137.","journal-title":"Psychiatr Times"},{"issue":"2","key":"e_1_3_5_36_2","first-page":"CD000076","article-title":"Electroconvulsive therapy for schizophrenia","volume":"18","author":"Tharyan P","year":"2005","unstructured":"Tharyan P, Adams CE. Electroconvulsive therapy for schizophrenia. Cochrane Database Syst Rev 2005; 18(2): CD000076.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_5_37_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2023.1290364"},{"key":"e_1_3_5_38_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.41159"},{"key":"e_1_3_5_39_2","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2021.37"},{"key":"e_1_3_5_40_2","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13134"},{"key":"e_1_3_5_41_2","doi-asserted-by":"publisher","DOI":"10.12703\/r\/12-13"},{"key":"e_1_3_5_42_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2023.1135583"},{"key":"e_1_3_5_43_2","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0000000000001142"},{"key":"e_1_3_5_44_2","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0000000000000729"},{"key":"e_1_3_5_45_2","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13215"},{"key":"e_1_3_5_46_2","doi-asserted-by":"publisher","DOI":"10.1002\/gps.70020"},{"key":"e_1_3_5_47_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000041674"},{"key":"e_1_3_5_48_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.28335"},{"key":"e_1_3_5_49_2","doi-asserted-by":"publisher","DOI":"10.1097\/JNN.0000000000000596"},{"key":"e_1_3_5_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2022.102236"},{"key":"e_1_3_5_51_2","doi-asserted-by":"publisher","DOI":"10.4103\/aian.AIAN_70_20"},{"key":"e_1_3_5_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2014.02.004"},{"key":"e_1_3_5_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2010.03.021"},{"key":"e_1_3_5_54_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1092852900020411"},{"key":"e_1_3_5_55_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2020.05.028"},{"key":"e_1_3_5_56_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajp.2024.104311"},{"key":"e_1_3_5_57_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2022.101589"},{"key":"e_1_3_5_58_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2019.11.002"},{"key":"e_1_3_5_59_2","doi-asserted-by":"publisher","DOI":"10.1111\/cns.13769"},{"key":"e_1_3_5_60_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-018-1941-x"},{"key":"e_1_3_5_61_2","unstructured":"Spring B Ferguson M Russell S et al. Evidence-based behavioral medicine (EBBM). In: Gellman MD Turner JR (eds). Encyclopedia of Behavioral Medicine. Springer pp. 718\u2013725."},{"key":"e_1_3_5_62_2","unstructured":"Turner JR. Hierarchy of evidence. In: Gellman MD (ed). Encyclopedia of Behavioral Medicine. Springer International Publishing pp. 963\u2013964."},{"key":"e_1_3_5_63_2","volume-title":"UC library guides: evidence-based practice in health: hierarchy of evidence","author":"University of Canberra Library","year":"2023","unstructured":"University of Canberra Library. UC library guides: evidence-based practice in health: hierarchy of evidence. University of Canberra Library, 2023. https:\/\/canberra.libguides.com\/c.php?g=599346&p=4149721 (accessed 11 April 2025)."},{"key":"e_1_3_5_64_2","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2022-006690"},{"key":"e_1_3_5_65_2","volume-title":"Academic guides: evidence-based research: levels of evidence pyramid","author":"Walden University","year":"2025","unstructured":"Walden University. Academic guides: evidence-based research: levels of evidence pyramid. Walden University, 2025. https:\/\/academicguides.waldenu.edu\/library\/healthevidence\/evidencepyramid (accessed 13 April 2025)."},{"key":"e_1_3_5_66_2","doi-asserted-by":"publisher","DOI":"10.1353\/pbm.0.0086"},{"key":"e_1_3_5_67_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1121189X00000671"},{"key":"e_1_3_5_68_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k5233"},{"key":"e_1_3_5_69_2","first-page":"4","article-title":"ECT: dangerous on either side of the pond","volume":"38","author":"Read J","year":"2021","unstructured":"Read J, Hancock S, Cunliffe S. ECT: dangerous on either side of the pond. Psychiatr Times 2021; 38: 4\u20136.","journal-title":"Psychiatr Times"},{"key":"e_1_3_5_70_2","article-title":"Raising doubts about ECT","author":"Hancock S","year":"2021","unstructured":"Hancock S, Cunliffe S, Read J. Raising doubts about ECT. Psychiatr Times 2021. https:\/\/www.psychiatrictimes.com\/view\/doubts-about-ect (accessed 12 July 2023).","journal-title":"Psychiatr Times"},{"key":"e_1_3_5_71_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(21)00506-X"},{"key":"e_1_3_5_72_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11126-021-09936-5"},{"key":"e_1_3_5_73_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2018.12.143"},{"key":"e_1_3_5_74_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2021.04.017"},{"key":"e_1_3_5_75_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.896018"},{"key":"e_1_3_5_76_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2023.09.014"},{"key":"e_1_3_5_77_2","doi-asserted-by":"publisher","DOI":"10.1159\/000118216"},{"key":"e_1_3_5_78_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0069809"},{"key":"e_1_3_5_79_2","doi-asserted-by":"publisher","DOI":"10.1093\/ijnp\/pyy085"},{"key":"e_1_3_5_80_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000005037"},{"key":"e_1_3_5_81_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2025.1511817"},{"key":"e_1_3_5_82_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000005311"}],"container-title":["International Journal of Risk &amp; Safety in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09246479251377340","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09246479251377340","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09246479251377340","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:45:50Z","timestamp":1777509950000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09246479251377340"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,5]]},"references-count":81,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1177\/09246479251377340"],"URL":"https:\/\/doi.org\/10.1177\/09246479251377340","relation":{"has-preprint":[{"id-type":"doi","id":"10.31219\/osf.io\/hvmk4","asserted-by":"object"}]},"ISSN":["0924-6479","1878-6847"],"issn-type":[{"value":"0924-6479","type":"print"},{"value":"1878-6847","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,5]]}}}