Research article summary (published 30 Aug 1996):

The "half-age" stimulation strategy for ECT dosing.

Full Abstract

Energy levels affect the treatment efficacy and efficiency of electroconvulsive therapy (ECT). United States devices require preselection of energy dosage before stimulating patients, and two strategies have been proposed to determine an effective dosage, i.e., based on the patient's age and measured estimates of seizure threshold. The age method is criticized for overstimulation and an assumed association with increased cognitive effects. Threshold determination strategy is cumbersome and requires multiple stimulations, possibly placing patients at increased cardiovascular risk. In 35 patients, we examined an energy estimate for bilateral electrode placement at half the patient's age in "percent of energy" or joules delivered by the Thymatron and MECTA devices. Each patient required one stimulation in the first treatment to elicit motor seizures averaging 51.7 s. Subsequently, 20 patients were randomly assigned to either threshold titration followed by half-age for the first two treatments or the opposite (AB-BA design). Half-age energy was 7 J (30%) higher than titration estimates, corresponding to 55% energy of the age method. The relation of half-age and titration estimates were confirmed in energy dosing records from two independent centers. Energy dosing by half-age calculation in bilateral ECT is simple, practical, avoids overdosing and repeat stimulation, and is a useful substitute for the more complex strategy based on threshold estimation.

Author information

Author/s: Petrides, G (G); Fink, M (M);

Affiliation: Department of Psychiatry and Behavioral Sciences, State University of New York at Stony Brook, USA.

Journal and publication information

Publication Type: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial

Journal: Convulsive therapy (Convuls Ther), published in UNITED STATES. (Language: eng)

Reference: 1996-Sep; vol 12 (issue 3) : pp 138-46

Dates: Created 1997/01/23; Completed 1997/01/23; Revised 2004/11/17;

PMID: 8872401, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Convuls Ther. 1997 Mar;13(1):37-43. (PMID: 9152587)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aging Electroconvulsive Therapy - methods Electroencephalography Female Humans

Male Middle Aged Mood Disorders - psychology; therapy Prospective Studies Psychiatric Status Rating Scales

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