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The pitfalls of dose titration as used in electroconvulsive therapy

  • P. O. Byrne (a1), R. G. Farquharson (a2) and I. S. Schofield (a2)
Abstract

Dose titration is the new colloquialism in ECT circles. The technique, as generally applied, assumes that current and the time for which it is passed, are equally important in the depolarisation of nerve cells. The units used to quantify its measurement, namely the milliCoulomb (mC) reflect this. We think this is misleading and suggest it ought not to be used as a parameter to describe a treatment regime. It is the aim of this communication to explain, in general terms, the physical parameters that control the current flowing in the patient's head, to suggest a more appropriate method to describe the treatment administered and outline the requirements of a good ECT machine.

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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.
References
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Abrams, R. (1992) Electroconvulsive Therapy. New York: Oxford University Press.
Offner, F. (1942) Electrical properties of tissues in shock therapy. Proceedings of the Society of Experimental Biology and Medicine, 49, 571574.
Sackeim, H. A., Devanand, D. P. & Prudic, J. (1991) Stimulus intensity, seizure threshold, and seizure duration. Psychiatric Clinics of North America, 14, 803843.
Sackeim, H. A., Devanand, D. P. Decina, P., Prohovnik, I. & Malitz, S. (1987) Seizure threshold in electroconvulsive therapy. Archives of General Psychiatry. 44, 355360.
Weaver, L., Williams, R., & Rush, S. (1976) Current density in bilateral and unilateral ECT. Biological Psychiatry, 11, 303312.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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The pitfalls of dose titration as used in electroconvulsive therapy

  • P. O. Byrne (a1), R. G. Farquharson (a2) and I. S. Schofield (a2)
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