Electroconvulsive therapy

Abstract

This chapter on electroconvulsive therapy (ECT) surveys the history of this effective treatment modality in psychiatry. It reviews the first publication introducing ECT, which was followed by rapid expansion throughout the world. Next, the important topic of memory impairment is reviewed. Thereafter, it discusses the technical modifications that resulted in less memory impairment, most notably unilateral electrode placement and brief-pulse square-wave electrical stimulation. The publication of a placebo-controlled trial establishing efficacy using modern research methods is also discussed. Finally, a controlled trial of continuation ECT is presented, which touches on the need to prevent relapse. The chapter can be appreciated by readers of any background, whether medical or not.