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Evidence and Challenges

Max Fink, MD; Michael Alan Taylor, MD

JAMA. 2007;298:330-332.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Electroconvulsive therapy (ECT) is a treatment for severe psychiatric illnesses. In 2001, a JAMA editorial¹ accompanying a report² of continuation medication treatments after ECT reviewed the evidence for efficacy, the risks of relapse, and the controversies in electrode placement and memory effects. Additional studies warrant another look at this treatment.

Present ECT techniques use sedation, muscle paralysis, ventilation with oxygen, and brief-pulse electrical stimuli that virtually eliminate the past risk of fracture and minimize transient cognitive dysfunctions.³ The mortality rate (about 2 deaths per 100 000 treatments) is less than that reported for normal childbirth and is associated with the anesthesia risks.³

Remission Efficacy for Depressive Illness

Many studies documenting the efficacy of ECT for depressive illness have been published,³ finding ECT superior to "sham" ECT and to medications in the treatment of patients with severe depressive illness. Two multisite collaborations—the Consortium for Research in ECT (CORE)⁴ and Columbia . . . [Full Text of this Article]

Author Affiliations: Departments of Psychiatry and Neurology, Stony Brook University (Dr Fink), Department of Psychiatry, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, and Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (Dr Taylor).

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