Practical issues in the use of electroconvulsive therapy (ECT)

ECT is a safe and effective treatment for affective disorders and certain types of schizophrenia. It is also useful as a form of continuation/maintenance therapy in otherwise resistant cases. The referral of a patient for ECT is based on a careful risk-benefit analysis of all viable treatment options. The administration of ECT in the present era is a refined, technically sophisticated procedure which should be performed only by practitioners with established competency to do so. With proper understanding of risk factors and treatment technique, modifications of the ECT procedure can now frequently be made to minimize adverse effects and to maximize therapeutic response.