Out on PubMed is this literature review and case series from clinician/investigators in Nantes, France:
Recurrence After Stopping Maintenance Electroconvulsive Therapy: A Retrospective Case Series.
Cabelguen C, Caillet P, Poulet E, Szekely D, Desmidt T, Pichot A, Vanelle JM, Sauvaget A, Bulteau S.J ECT. 2020 Jun 12. doi: 10.1097/YCT.0000000000000693. Online ahead of print.PMID: 32558761
The abstract is at the above link and partially copied here:
Methods: A comprehensive [literature] review was conducted, followed by a retrospective analysis of 18 cases of mECT discontinuation between January 2011 and June 2016 involving patients with affective disorders.
Results: The comprehensive review revealed that only 3 studies have assessed recurrence rate after c/mECT discontinuation. In our retrospective analysis, mean (SD) mECT duration was 12.69 (12.16) months. A new mood event (usually a depressive state) was observed in 50% of the cases, and 44% of those recurrences occurred during the first 6 months after discontinuation.
Discussion: Given that high recurrence rates are observed after mECT discontinuation, the authors discuss the advantages of long-term mECT and the choice of concomitant pharmacotherapy for severe and complex affective disorders.
And from the text:
In any case, patients with complex mood disorders could benefit from an extended mECT schedule with optimized concomitant pharmacotherapy...There is a need for predictive markers and large prospective studies addressing precise clinical characteristics and medical histories, including comorbidities, concomitant pharmacotherapy, and neuroimagering. This is especially crucial for more precise characterization of patients who are at risk for recurrence upon mECT discontinuation and who would benefit from long-term prevention through mECT.
These authors found only three studies in the literature addressing the issue of relapse after mECT discontinuation and contributed their 16 additional patients (2 were double-counted). In their discussion they highlight the special role of lithium in relapse prevention and point out that it is under prescribed.
Experienced practitioners know that there is a cohort of patients with such severe and recurrent mood or psychotic disorders that ongoing long-term, sometimes even life-long, mECT is the best therapeutic option.


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