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Updated: Nov 2, 2025

Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy
Published on: April 11, 2019
Changes in seizure duration during acute course electroconvulsive therapy.
James Luccarelli1, Thomas H McCoy2, Stephen J Seiner3
1Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, McLean Hospital, Belmont, MA, USA; Harvard Medical School, Boston, MA, USA.
Electroconvulsive therapy (ECT) seizure duration shortens during treatment, particularly in the initial sessions. Higher electrical doses and increasing treatment numbers correlate with shorter seizures, impacting ECT efficacy.
Area of Science:
- Neuroscience
- Psychiatry
- Medical Technology
Background:
- Seizure duration is a potential marker for electroconvulsive therapy (ECT) efficacy.
- Short seizures during ECT may indicate reduced clinical effectiveness.
- Large cohort data are needed to understand seizure duration changes during ECT treatment.
Purpose of the Study:
- To analyze factors influencing electrographic seizure duration during acute ECT.
- To investigate the impact of age, sex, ECT dose, and treatment number on seizure duration.
- To establish normative data for seizure duration changes in a large ECT cohort.
Main Methods:
- Retrospective chart review of adult patients receiving ECT.
- Inclusion of data from a large single-center psychiatric hospital (2000-2017).
- Analysis of 3648 patients and 32,879 acute course ECT treatments.
Main Results:
- Mean ECT seizure duration shortened throughout the acute treatment course.
- Greatest duration decrease observed within the first three treatments.
- Older age, higher ECT dose, and increased treatment number were associated with shorter seizures.
- Increased electrical charge correlated with shorter seizure durations.
Conclusions:
- Seizure duration consistently decreases during acute ECT treatment.
- Higher electrical doses are linked to shorter electrographic seizures.
- Understanding these changes is crucial for optimizing ECT treatment protocols.
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