Electrical dose titration for electroconvulsive therapy: a comparison with dose prediction methods

Recent literature on electroconvulsive therapy (ECT) emphasizes the use of moderately suprathreshold electrical stimuli for clinical ECT. Since there is substantial interpatient variability in seizure thresholds, individualization of the ECT stimulus dose has been advocated. Three methods for selecting an electrical stimulus are compared in the present study. The methods compared include empirical titration and dose predictive methods described by two different ECT equipment instruction manuals. The use of ECT stimulus titration was found to be a more consistent means of selecting an electrical dose than either of the two predictive methods. The implications of these findings for the clinical practice of ECT are discussed.