Choosing a Dosing Strategy for Electrical Stimulation in ECT

Letter to the Editor

Sir: We are writing to address some issues raised by Shapiraet al., (January 1996 issue). The authors report the variabilityand the relation of seizure threshold estimates to the efficacy ofelectroconvulsive therapy (ECT) with bilateral electrode placement.They state that the "initial seizure threshold for pulse bilateralECT is highly variable and not yet amenable to accurateprediction" and recommend the stimulus titration method as it"allows threshold to be determined on an individual basis anddosage for subsequent treatments to be defined."