The Dilemma of Unmodified Electroconvulsive Therapy

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Electroconvulsive therapy (ECT) was introduced in1938, in an era in which antidepressant and antipsychoticdrugs were unknown.^1,2 Today, over 6 decades later, despite the availability of a large number of psychopharmacologic agents for the treatment of depression and psychosis, ECT remains an important method of treatment inpsychiatry. This is because ECT can be life-saving in catatonic, suicidal, or otherwise severely disturbed patients,²because it is of exceptional benefit to patients with psychotic depression,³ and because it can be therapeutic^4-6 aswell as prophylactic⁷in patients who do not respond toantidepressant or antipsychotic drugs.’ ‹’ ‹