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Highlights

  • Sir: In 'Psychiatric emergencies in people with a mental handicap' Psychiatric Bulletin, 1993, 17, 587-589) Dora Kohan write

  • Sir: I found the paper by Gee & White (Psychiatric Bulletin, 1993, 17, 606-607) where they stress the need for a formal restimulation policy in ECT very useful as we are working on a similar policy

  • Timing of seizure duration should be viewed as a form of process outcome measure for the procedure but the confounding effect of muscle relaxant suggests that the cuff technique should be routinely employed (Addersley & Hamilton, 1953)

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Summary

Restimulation with ECT

Sir: I found the paper by Gee & White (Psychiatric Bulletin, 1993, 17, 606-607) where they stress the need for a formal restimulation policy in ECT very useful as we are working on a similar policy. Timing of seizure duration should be viewed as a form of process outcome measure for the procedure but the confounding effect of muscle relaxant suggests that the cuff technique should be routinely employed (Addersley & Hamilton, 1953). It should be stressed that the 25 seconds mini mum is not based upon clinical outcome studies, and there has not as yet been a demonstration that actual seizure duration is clinically relevant, the presence of a seizure is. The American studies use EEG seizure measures, so if a minimum adequate fit duration is ever demonstrated, it will be shorter by at least 10% in the UK as we use motor seizure timings (Fink & Johnson, 1982). LITTLEJOHNSD, eestde Community Mental Health Team, Deeside, Clwyd CH5 4DD

Care of people with a mental handicap
Audit of outcomes
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