Worry about memory is the single most common reason people hesitate about ECT. This 2024 review pulled together ten studies covering 868 people with major depression to look specifically at the long-term picture.
Its conclusion is more interesting than a simple yes or no. The researchers argue that much of the long-running disagreement about whether ECT causes lasting memory problems comes down to the tools being used. General cognitive tests, the kind used in most older studies, are not sensitive enough to pick up the specific things ECT can affect — so they often find nothing.
When the researchers looked at studies using a newer instrument designed for this purpose, they did find evidence of a lasting effect, particularly on longer-term memory.
That is worth saying plainly rather than glossing over: this review supports the concern, it does not dismiss it. What it also shows is that the honest answer requires better measurement than we have usually used, and the average study may have been reassuring for the wrong reason.
None of this means ECT is the wrong choice — for severe depression it can be lifesaving. It means the trade-off is real and deserves a proper conversation with your treating psychiatrist.