Successful use of left-unilateral electroconvulsive therapy in a right-handed male

This case report details the use of left-unilateral electroconvulsive therapy (ECT) chosen for this right-handed male for medical reasons outlined in the article. Continuation/maintenance ECT was extended for approximately 1 year from the beginning of Index ECT. He responded well to the index series and continued to respond to the follow-up ECT. His Hamilton Depression Rating scores were close to remission 4 weeks after the last ECT. His Mini-Mental Status Examination scores were essentially unchanged comparing pre-ECT and post-ECT scores. The literature on left-unilateral ECT is reviewed. Earlier reports reported more negative cognitive effects with left-unilateral ECT compared with right-unilateral ECT. The most recent series indicated efficacy for both right and left-unilateral ECT but with faster improvement, especially from the third to sixth ECT for the left-unilateral procedure. There is some support for using left-unilateral ECT because it appears to have less negative cognitive effect than bilateral ECT. This case supports the efficacy of left-unilateral ECT without adverse cognitive changes.