How Relevant is Seizure Duration in Assessing the Effectiveness of Electroconvulsive Therapy?

Abstract

Dear Editor: Electroconvulsive therapy (ECT) is a highly effective treatment for major depression and other psychiatric disorders. The question of how to define a therapeutically adequate ECT treatment has been discussed from the early days of ECT (1) to the present (2). Although convention has required a minimum individual seizure duration of 15 to 25 seconds (3,4) or a total seizure duration of more than 200 seconds (5), the complex electrophysiological events involved in developing a generalized seizure make it problematic to link the therapeutic efficacy of ECT to seizure duration only. We describe the case of a patient with severe depression who completely recovered despite receiving ECT that generated only brief motor seizures.