Prog. Neuro-Psychopharmacol, b Biol. Psychiat. 1987. Vol. 11. pp. 179-184 0278-5846187 $0.00 + .50 Printed in Great Britain. All rights reserved. Copyright 0 1987 Pergamon lournals Ltd. zyxwvut MEMORY EFFECTS OF RESTRICTED ENVIRONMENTAL STIMULATION THERAPY (REST) AND POSSIBLE APPLICATIONS TO ECT PETER SUEDFELD, CARMEN E. RAMIREZ, RONALD A. REMICK, and JONATHAN A. E. FLEMING Departments of Psychology and Psychiatry, University of British Columbia Vancouver, British Columbia, Canada (Final form, December 1986) Abstract Suedfeld, Peter, Carmen E. Ramirez, Ronald A. Remick, and Jonathan A. E. Fleming: Memory Effects of Restricted Environmental Stimulation Therapy (Rest) and Possible Applications to ECT. Prog. Neuro-Psychopharmacol. & Biol. Psychiat. 1987, 11: 179-184. Restricted environmental stimulation (REST) has been shown to facilitate learning and memory in both human and animal experimental subjects. This paper reports early data from a test of the usefulness of REST in reducing post-ECT amnesia in depressive patients. Two such patients were placed in a quiet, dimly illuminated room for 2-4 hrs. after recovering from each ECT administration in a series of treatments; three others, following standard practice, were returned to their normal hospital rooms. Measures of memory (verbal, numerical, nonverbal, life event, and self-rating) were given prior to the first ECT treatment; after the first post-recovery session; after the last post-recovery session; and one week after the last ECT administration. The major difference found was that the REST group showed an improvement in self-rated memory functioning from the first to the last ECT administration that was 15 times as great as that reported by the control group. This finding is interesting because of the major role played by self-reported memory disturbances in the scientific, clinical, and popular evaluation of ECT. The sample size is being increased, as it must be for any reliable conclusions to be drawn from this study. Keywords: amnesia, ECT, memory, restricted environmental stimulation, REST. Abbreviations: electroconvulsive treatment (ECT), restricted environmental stimulation therapy (or technique) (REST). Introduction Most of the research literature on the memory effects of ECT has been devoted to two primary issues. One of these is to establish what these effects actually are. and the other is to find methods that would prevent or at least minimize adverse effects. These endeavours have been proceeding for several decades, as the possibility that ECT may cause serious and long-lasting cognitive deficits first arose and then became a widely publicized issue. As any review of popular or professional writings indicates, the problem is still attracting considerable attention. The answer to the first question. the nature of ECT effects, depends on many factors. Among these are the kind of memory and memory disruption being tested: long-term, short-term. iconic. verbal, nonverbal, anterograde. retrograde. etc. The kind of test used is also important. since a wide range of objective, self-report, and observational measures do not necessarily yield identical results. Last, such variables . . as the tunmg, number and frequency of tests, the use of alternate but equivalent test forms, the inclusion of appropriate control conditions, etc., also affect the conclusions. To summarize the data. there may be no definitive answer to the general 179