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Initial seizure threshold in bilateral electroconvulsive therapy

  • Sheena R. Dykes (a1) and Allan I. F. Scott (a1)
Abstract

The extent to which electrical dose exceeds the seizure threshold is an important determinant of the efficacy of electroconvulsive therapy (ECT) but seizure thresholds have not before been evaluated using an ECT machine made in the UK. In this study seizure threshold was empirically titrated at the outset of bilateral ECT given to 100 consecutive depressed patients treated with an Ectron Series 5A ECT machine. No patient received anti-epileptic drugs. Men and women under 30 years of age (n=14) had low thresholds and men of 60 years or more (n=3) had high thresholds. Seizure thresholds varied at least threefold among other groups, suggesting that empirical titration may be desirable for most patients treated by bilateral ECT.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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References
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Abrams, R. (1992) Electroconvulsive Therapy (2nd edn). Oxford: Oxford University Press.
American Psychiatric Association (1990) The Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training and Privileging. Washington, DC: APA.
ECT Sub-Committee of the Research Committee, Royal College of Psychiatrists (1989) The Practical Administration of Electroconvulsive Therapy (ECT). London: Gaskell.
Royal College of Psychiatrists (1995) The ECT Handbook. The Second Report of the Royal College of Psychiatrists Special Committee on ECT, Council Report CR39. London: Royal College of Psychiatrists.
Sackeim, H. A. (1991) Are ECT devices underpowered? Convulsive Therapy. 7, 233236.
Sackeim, H. A., Devanand, P. & Prudic, J. (1991) Stimulus intensity. seizure threshold, seizure duration: impact on the efficacy and safety of a electroconvulsive therapy. Psychiatric Clinics of North America, 14, 803843.
Swartz, C. M. & Abrams, R. (1994) ECT Instruction Manual Lake Bluff, IL: Somatics Inc.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Initial seizure threshold in bilateral electroconvulsive therapy

  • Sheena R. Dykes (a1) and Allan I. F. Scott (a1)
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