The Dilemma of Unmodified Electroconvulsive Therapy

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Electroconvulsive therapy (ECT) was introduced in 1938, in an era in which antidepressant and antipsychotic drugs were unknown.1,2 Today, over 6 decades later, despite the availability of a large number of psychopharmacologic agents for the treatment of depression and psychosis, ECT remains an important method of treatment in psychiatry. This is because ECT can be life-saving in catatonic, suicidal, or otherwise severely disturbed patients,2 because it is of exceptional benefit to patients with psychotic depression,3 and because it can be therapeutic4–6 as well as prophylactic7 in patients who do not respond to antidepressant or antipsychotic drugs.​​

J Clin Psychiatry 2003;64(10):1147-1152