Electroconvulsive therapy. Indications and contraindications

The indications for convulsive treatment are such that, when it is properly used, it is one of the most effective treatments in the whole of medicine. Its chief indication is for depressive illness that shows predominantly biological features. It is particularly useful for patients who have not responded to other treatments and for those who are actively suicidal. Research on the prediction of response has yielded very little information beyond that already based on clinical experience. In the right conditions it is remarkably safe and has few contraindications. In a way it corresponds to a "surgical" treatment and, therefore, it is to be hoped that when its mode of action is adequately elucidated, it will be replaced by "medical" treatments.