Treatment optimization with ECT.

Although electroconvulsive therapy (ECT) is considered to be an effective and safe treatment, as with any treatment, both therapeutic outcome and adverse effects can be expected to vary considerably across patients. It is incumbent upon the practitioner to be aware of factors that serve to influence the benefits and risks associated with this treatment modality. This article provides a brief, clinically oriented overview of many of these factors, including those that may be useful in response prediction, as well as technical modifications of the ECT procedure itself. In addition, a number of suggestions are made concerning promising future avenues of research in this area.