Even your study that (you claim) says it doesn’t work basically concludes it works for depression? I’ve only seen it used in treatment-resistant depression and it’s worked from what I’ve seen. But that’s like 2 people

Edit: I’m not convinced you read those studies actually….

However, subgroup analysis showed that the risk of recurrence was significantly lower in patients receiving ECT with antidepressant therapy compared to the antidepressant group alone

The present meta-analysis showed that ECT, in combination with pharmacotherapy, effectively reduced the risk of relapse and recurrence at the end of the study trial… This shows a potential synergistic role for ECT and psychotropic drugs in the maintenance treatment of depression.

So, it works? The second study has a couple issues though. As the first one points out, ECT does not work as well (though still pretty well) on Bipolar individuals, yet the second study lumps bipolar and unipolar depression together. The study also acknowledges that maintenance ECT sessions are not consistent across studies, which is a major issue. Obviously if you aren’t doing follow up visits, you have a higher risk of relapse. This is the study you claimed showed it was not better than other treatments.

They also state:

a meta-analysis by Dong et al. [20] found that ECT was superior to maintenance antidepressant therapy in preventing depression recurrence.

Back to the first study…. It’s about kids. Even within the study, they acknowledge it seems to work better on older children. So that study doesn’t say it doesn’t work, it says it doesn’t work as well on younger children. It also acknowledges:

A retrospective cohort study showed the risk of suicide was found to be significantly reduced for adults with MDD who received ECT.

In other words, while it may only “work” on up to 70% of patients, it might mitigate the most severe symptoms of depression and prevent suicide.

Basically, I don’t see anything in what you shared that calls ECT ineffective or controversial. Even the “negative” study you shared indicates it works. It does not focus on treatment-resistant depression though, which is the most interesting application.