Change in seizure threshold during electroconvulsive therapy
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Updated: Jul 4, 2026

Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy
Published on: April 11, 2019
Max Fink1, Georgios Petrides, Charles Kellner
1Long Island Jewish-Hillside Hospital, Glen Oaks, NY, USA. mafink@attglobal.net
Unlabelled:
The seizure threshold (ST) is a measure of the minimum electrical energy necessary to induce a grand mal seizure. Dose titration of the ST has been suggested to optimize stimulus dosing in electroconvulsive therapy (ECT). The change in ST with remission is examined in a large sample of unipolar depressed patients.
Methods:
In a study of continuation treatments after successful ECT, the ST was determined at the first treatment and again 1 week after remission using a conventional ST measurement protocol. Patients were treated with bilateral electrode placement at 150% above the measured ST.
Results:
In 80 subjects, the ST measured the same in 70%, increased in 21%, and decreased in 9% at remission.
Conclusions:
In a study of bilateral ECT, the ST did not rise conclusively with remission.
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