ECT's increasing evidence base and positive profile

doi:10.1136/bmj.b390

Published 2 February 2009, doi:10.1136/bmj.b390
Cite this as: BMJ 2009;338:b390

Letters

Electroconvulsive therapy

ECT’s increasing evidence base and positive profile

The first 150 words of the full text of this article appear below.

Webber’s article on his wife’s experience of electroconvulsivetherapy (ECT) adds to an increasing body of positive and balancedaccounts of this controversial treatment.¹ ² ³

Webber highlights the use of continuation/maintenance ECT ona weekly to monthly basis after the acute treatment episodeto prevent the relapse of major depression. Continuation treatmentis arbitrarily defined as up to six months after an acute episode,and maintenance treatment as after six months. ECT was comparedwith nortriptyline and lithium in a randomised controlled trialfor six months in 201 patients with unipolar depression thathad remitted with an acute course of ECT.⁴ The relapse ratesfor both treatment arms were similar but significantly superiorto a historical placebo control. Both treatments had limitedefficacy and a high number of drop outs, but continuation ECT,rather than antidepressant treatment, was raised as a therapeuticoption after an acute course of ECT.