The shock induced a fit and kept the squealing animals subdued. After some experimentation on dogs, Cerletti felt ready in 1938 to test his method on a human, believing that he could treat acute schizophrenia, manic depression and major depression by causing a seizure.

The chosen subject was a Milanese man, a schizophrenic with delusions and hallucinations. Electrodes were applied to his temples, an orderly put a rubber tube between his teeth to stop him biting his tongue and the electricity was applied. After 10 treatments, they claimed the patient was released "in good condition" and a year later he had not relapsed.

Now, 69 years on, a refined version of electroconvulsive therapy (ECT) is being used in Ireland and many other countries around the world.

In Ireland, it is carried out under general anaesthetic and the resulting seizure lasts between 30 and 90 seconds. Its portrayal in films such as One Flew Over The Cuckoo's Nest conjures up an image of an inhumane abuse of power by men in white coats. And depending on who you talk to today, that stereotype is either widely supported or discredited.

Mary Maddock (59), from Rochestown, Cork, can't recall the birth of her first child in 1976 as ECT wiped this memory entirely. The treatment was carried out in a Cork hospital without her consent because she was an involuntary patient. Such consent is still not needed when the procedure is being carried out today if two psychiatrists agree. "I had become depressed and then became worse immediately after the birth, " she told the Sunday Tribune.

"The ECT was involuntary. I don't remember having my daughter at all. I never gave birth to another child after that experience. We adopted instead. Having a child should have been such an important moment, but it's just gone."

The procedure is not as uncommon in Ireland as many may think. In 2003 (the only year for which statistics were gathered), 745 people underwent this form of therapy, according to the Health Research Board. Next year, the Mental Health Commission will collate statistics on the number of people who underwent ECT. Under the Mental Health Act 2001, which was implemented last November, the use of ECT for involuntary patients is permitted without their consent as long as the psychiatrist has sought the second opinion of another psychiatrist and they agree it is necessary. Under the act, guidelines have been introduced for ECT's usage and each hospital must this year submit an annual report concerning its use. "For the first time, we have rules in relation to ECT and its usage now must be reported and documented, " said a spokeswoman for the Mental Health Commission.

"Before this, there was no actual legislation."

While psychiatrists agree that shortterm memory loss is a side-effect of the treatment, some patients, including Maddock, say they are living with longterm detrimental side-effects. "My memory is still affected, " said Maddock. "ECT has affected my ability to work; I used to be a music teacher. I get confused, I can't do things my friends can do. To injure someone's brain in the name of health is barbaric." Maddock had ECT again when she was 35 at St Patrick's Hospital in Dublin when she had a relapse of psychosis. "I've had 18 to 20 shocks altogether. It's one of the most horrific symbols of the power of psychiatry."

Along with her husband Jim, Maddock has written a newly-published book about her experiences in the mental-healthcare system entitled Soul Survivor: A Personal Encounter of Psychiatry.

After years of medication for mental illness, she is now free of all drugs. Along with her husband, she travels to conferences around the world and speaks about the benefit of rehabilitation from mental illness without over-reliance on medication and ECT.

Dr Michael Corry, a psychiatrist in private practice in Dublin, sees a number of clients who have come to him following ECT treatment. "It doesn't affect everyone badly but it does some people. I have one young girl who had it done about three years ago when she was 17. She was being bullied in school and was suffering from depression. She had begun cutting herself. She was in a private institute and she had it carried out. She was a straight-A student but she's never returned to do her Leaving Cert because of it."

Corry maintains ECT can have longterm cognitive effects on some patients because it causes a concussion and results in some cases in a closed head injury. "It would be like if I hit you in the head with a hurley. Your brain would go into shock. But some patients I've seen have lost their ability to concentrate, make decisions. They now have permanent slowed-up thinking, " he said.

Prof Patricia Casey, a psychiatrist at Dublin's Mater Hospital who has carried out the procedure numerous times, utterly rejects Corry's assertions.

"It's a treatment in very limited use for a very specific group of patients with very specific symptoms. It is for extreme cases where people are so psychotically depressed that they cannot engage with anything and are a danger to themselves."

Notwithstanding individual accounts in Ireland and further afield that ECT can have longterm effects, Casey says there is no scientific proof to support this. "I would have ECT myself if I needed it. It's written into my pre-nup that, if I'm profoundly depressed, I should have it done even if I disagree."

Writer Sylvia Plath, musician Lou Reed and designer Yves Saint Laurent have all had ECT.

Plath went on to gas herself in the oven. Ernest Hemingway is undoubtedly the most famous patient of the treatment and killed himself shortly after having it. He told his biographer: "What is the sense of ruining my head and erasing my memory, which is my capital, and putting me out of business? It was a brilliant cure but we lost the patient."

Roisin McConnell from Donegal, whose husband Mark was wrongly accused of the murder-that-never-was of Donegal cattle dealer Richie Barron, underwent ECT in 1996. She developed serious psychiatric illness after she was taken into garda custody over the allegations concerning her husband. The treatment was effective for McConnell and she is now on the road to recovery.

In 2003, 141 patients received ECT in St Patrick's Hospital in Dublin, compared to 292 in 2001. Dr Jim Lucey, consultant psychiatrist at the hospital, recently carried out a survey of 51 patients who had ECT treatment there. "It is rarely used nowadays. Shortterm loss of memory was experienced by nearly six out of 10 patients.

"Significantly, these patients said that this would not put them off having ECT in the future.

This is because the relief of their disorder was so important to them, " he says.

However, US campaigner for patients' rights Dr Peter Breggin strongly rejects such studies.

"Some patients do feel 'helped' by ECT. Often they have been so damaged that they cannot judge their own condition."

Dr Corry, along with a handful of other psychiatrists in Ireland, maintain a small but vocal campaign condemning the use of ECT. They insist that, while many patients suffer no adverse long-term effects from the treatment, a proportion do and this amounts to abuse.

As for Maddock, she feels she will never fully recover from it but refuses to let it hamper her life. "It's always there. But I've been off all medication for five years having been told I'd be on it for the rest of my life. Now, after all these years, I feel capable. I feel I could do anything."

John's ECT story

JOHN McCarthy, who ran as an independent candidate in the general election in Cork North Central, was "at the door" to receive electric shock treatment a few years ago but his wife stopped it. He was suffering from severe depression at the time and was a patient at St Patrick's Hospital in Dublin.

He is now attempting to challenge the constitutionality of the Mental Health Act 2001, which allows two psychiatrists in agreement to administer ECT to a hospital in-patient without the patient's consent. He has contacted a solicitor in Cork and said legal action may be forthcoming.

McCarthy has been awarded a substantial sum by the One Foundation . . . a charitable organisation that funds research projects . . . to travel the country and meet people who say they have been adversely affected by ECT or been mistreated generally within the mental-health services. "Thank god for my wife or I may not be able to pursue this work because of the potential effect of ECT, " he said. "I had severe depression due to a traumatic event that happened in my life. I fell into a gap and was depressed. But I did not need ECT."

McCarthy's compilation of a number of accounts of the impact of ECT is to be published in book form. He believes it may also lead to litigation against psychiatrists and hospitals for personal injury claims, as is now occurring in the US.

ECT stories

A 28-YEAR-OLD Dublin woman who had ECT involuntarily five years ago said it was "a horrific experience to go through".

"I was stressed at college and moved abroad. I was depressed and had a psychotic event. The drugs weren't working and ECT was the last alternative. My parents signed the consent." The young woman has recovered from mental illness but said she lives with the fear that ECT "has affected my intelligence".

"I researched ECT afterwards and it opened my eyes as to how appalling the mental-healthcare system is in Ireland. It was a journey to hell and back."

Despite her experience, she does not believe ECT had a longterm detrimental impact on her. "I'm lucky. I was determined not to let it affect me. I've turned it into a positive experience but the trauma has stayed with me."

Meanwhile, a middleaged woman who had ECT a number of years ago following a manic episode said it had a major damaging impact on her life. "It has turned my life upsidedown. I have no sense of direction and my memory is still badly affected, even now." The woman, from the southeast, had been studying in university at the time but was never able to return to her studies.

She is now considering legal action against the hospital involved. "It was involuntary. I would never have agreed to it because I'd seen the impact of it on another member in my family. I wasn't able to think anymore after having it done. I'm unemployed. I cannot find a job. It has led to panic attacks and filled me with a sense of fear."

Both woman spoke on condition of anonymity and stressed that there was still a strong stigma attached to ECT and mental illness.