The efficiency of ECT: I. Response rate in depressive episodes.

A great deal of variation in opinion and practice remains regarding the most efficient use of electroconvulsive therapy (ECT) in treating depression. In this study we used an estimate of maximal improvement point to look at the rate of response to conventional ECT (one seizure per session, three times per week) in 66 patients with depressive episodes. Of the variables examined, increasing age was found to be significantly associated with slower response rate. Comparison of our results with studies of the multiple seizure technique suggests that giving multiple seizures per session does not speed response rate. We therefore conclude that within the limits of current clinical practice age is probably more important than number of frequency of seizures in determining the rate at which depression responds to ECT.