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Choosing a Dosing Strategy for Electrical Stimulation in ECT

J Clin Psychiatry 1996;57(10):488 [letter]

Letter to the Editor

Sir: We are writing to address some issues raised by Shapira et al., (January 1996 issue). The authors report the variability and the relation of seizure threshold estimates to the efficacy of electroconvulsive therapy (ECT) with bilateral electrode placement. They state that the “initial seizure threshold for pulse bilateral ECT is highly variable and not yet amenable to accurate prediction” and recommend the stimulus titration method as it “allows threshold to be determined on an individual basis and dosage for subsequent treatments to be defined.”