Is bilateral ECT ever indicated?

To investigate whether it is indicated to make a shift to bilateral technique when the first 6-10 unilateral ECT treatments have produced no improvement in patients with endogenous depression, a retrospective study was made concerning 61 patients 34 of whom (group U) continued with unilateral treatment while in 27 (group UB) a shift was made to bilateral technique. No significant differences were found between the groups with regard to final therapeutic result, only a tendency to better effect in the first mentioned group. This tendency can be explained by the somewhat higher age in this group. The duration of seizures, administration of benzodiazepines, as well as treatment with antidepressive drugs, were equal in the groups, which were thus comparable. It is concluded that since bilateral ECT may severely impair memory for weeks or months the patients should not be stressed by a change to this technique.