[The practice of electroconvulsive therapy: current contributions. I.--Indications, contraindications and adverse...

In this first of a two-part review about electroconvulsive therapy (ECT) practice, the author reviews main treatment indications, contraindications and complications. Major diagnostic indications are major depression, mania and some other functional psychoses. Other indications, primary use of ECT, and use in special population (children, adolescents, elderly, pregnancy) are also discussed. There are now no absolute contraindications to treatment but high risk situations. Cardiovascular complications are the leading cause of post-ECT morbidity, as are, but at a least degree, prolonged and tardive seizures. Factors that contribute to cognitive side effects are also presented.