Indian Journal of Psychological Medicine
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Year : 2020  |  Volume : 42  |  Issue : 3  |  Page : 207-218

Frequency and duration of course of ECT sessions: An appraisal of recent evidence

1 Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
2 Consultant Psychiatrist, Bradgate Mental Health Unit, Leicester, England, UK

Correspondence Address:
Dr. Jagadisha Thirthalli
Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru - 560 029, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IJPSYM.IJPSYM_410_19

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Aims and Method: This paper aims to review the recent literature regarding factors influencing the frequency and number of sessions during a course of electroconvulsive therapy (ECT) for different psychiatric disorders. We systematically reviewed English-language papers of clinical trials of ECT published since the year 2000 in terms of frequency and number of sessions of ECT. Results: None of the 30 studies meeting our inclusion criteria were specifically designed to study frequency or number of sessions of ECT. A preliminary inference may be drawn regarding the number of sessions from the information available in these papers. For depression, patients receiving brief-pulse ECT needed fewer sessions than those receiving ultra-brief ECT when these were delivered at 8-times the threshold with unilateral electrode placement or at 2.5-times the threshold with bilateral placement. For schizophrenia, those receiving bifrontal ECT and ECT at 4-times the threshold-level stimulus needed fewer sessions than those receiving bitemporal ECT and 2-times the threshold-level stimulus, respectively. There were no clinical trials of the frequency of ECT sessions.Clinical Implications: A s there is a dearth of studies specifically examining frequency and number of ECT sessions, broad recommendations from professional bodies should continue to guide practice.

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