Classics in ECT: Scott on Continuation ECT, British Journal of Psychiatry 1991

 "Classics in ECT" brings you this paper from the British Journal of Psychiatry from 1991:

Continuation electroconvulsive therapy: preliminary guidelines and an illustrative case report.

Scott AI, Weeks DJ, McDonald CF.Br J Psychiatry. 1991 Dec;159:867-70. doi: 10.1192/bjp.159.6.867.PMID: 1790461
The abstract is copied below:
Despite renewed interest in ECT as a continuation treatment after an episode of depressive illness, few guidelines for its use are available. Meaningful research findings are few, although the potential benefits and risks of modern continuation ECT merit study. We suggest preliminary guidelines and provide an illustrative clinical example.

The article is here.



This is an excellent short article from the early days of the explosion of reports on maintenance ECT three decades ago. The case report of recurrent psychotic depression with failure to respond to (presumably) low-dose RUL ECT, but good response to BL ECT, is instructive. The reference to the recent early work of Sackeim is quaint. The nomenclature issue ("maintenance ECT", "continuation ECT") resulted in a subsequent LTE by Susan Benbow, which will be a future blog post.
We have come quite a way in the meantime to establish maintenance ECT as a legitimate, standard practice, but there are still outstanding clinical issues (optimal schedules, best technique) to refine further.
I recommend a full read of this paper to all ECT practitioners, ~ 10 minutes.
  


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