Abstract

The extent to which electrical dose exceeds the seizure threshold is an important determinant of the efficacy of electroconvulsive therapy (ECT) but seizure thresholds have not before been evaluated using an ECT machine made in the UK. In this study seizure threshold was empirically titrated at the outset of bilateral ECT given to 100 consecutive depressed patients treated with an Ectron Series 5A ECT machine. No patient received anti-epileptic drugs. Men and women under 30 years of age (n=14) had low thresholds and men of 60 years or more (n=3) had high thresholds. Seizure thresholds varied at least threefold among other groups, suggesting that empirical titration may be desirable for most patients treated by bilateral ECT.

Highlights

  • Theextent to which electrical dose exceeds the seizure threshold is an important determinant of the efficacy of electroconvulsive therapy (ECT)but seizure thresholds have not before been evaluated using an ECTmachine made in the UK

  • Whereas earlier guidelines from the College made no reference to the seizure threshold and advised only that the length of the convulsion be used to assess therapeutic adequacy (ECT Sub-Commit tee of the Research Committee, 1989). the latest guidelines recommend that the electrical dose be adjusted for each patient to take into account the variation in seizure threshold (Royal College of 'Pstsiymcuhliuatsristds.osing1'.995)

  • The aim of the present study was to measure empirically initial seizure thresholds in bilateral ECT given with the Ectron Series 5A

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Summary

Introduction

Theextent to which electrical dose exceeds the seizure threshold is an important determinant of the efficacy of electroconvulsive therapy (ECT)but seizure thresholds have not before been evaluated using an ECTmachine made in the UK. There are two approaches to stimulus dosing: the empirical measurement of the seizure thres hold by a technique of dose titration or the routine administration of a predetermined dose dependent on the laterality of treatment, and the age and the gender of the patient The aim of the present study was to measure empirically initial seizure thresholds in bilateral ECT given with the Ectron Series 5A

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