Electroconvulsive Therapy: Current Clinical Standards

Abstract

symptoms have existed since the early 1900s. They were developed in response to the observation that patients who suffered from endogenous seizures demonstrated relief from psychiatric symptoms. Although most of these methods were abandoned because of high rates of morbidity and mortality, the use of electrically induced controlled seizure activity to treat psychiatric disorders continued to attract attention. Over the years, ongoing refinements in the method of administrating electroconvulsive therapy (ECT) have included: • Optimization of the dosing and localization of electrical charge; • Use of anesthesia; and • Psychiatric and medical screening of patients to assess their appropriateness for treatment and to anticipate potential adverse events. As a result, ECT has become one of the safest and most broadly effective treatments, particularly for major depressive disorder (MDD). We discuss the indications for ECT, describe its administration, outline its important side effects and issues related to screening for medical risk, and review recent advances.