A naturalistic comparison of two right unilateral electroconvulsive therapy dosing protocols: 2-3X seizure threshold versus fixed high-dose

Ward, W. K., Lush, P., Kelly, M. and Frost, A. D. J. (2006) A naturalistic comparison of two right unilateral electroconvulsive therapy dosing protocols: 2-3X seizure threshold versus fixed high-dose. Psychiatry And Clinical Neurosciences, 60 4: 429-433.


Author Ward, W. K.
Lush, P.
Kelly, M.
Frost, A. D. J.
Title A naturalistic comparison of two right unilateral electroconvulsive therapy dosing protocols: 2-3X seizure threshold versus fixed high-dose
Journal name Psychiatry And Clinical Neurosciences   Check publisher's open access policy
ISSN 1323-1316
Publication date 2006
Sub-type Article (original research)
DOI 10.1111/j.1440-1819.2006.01527.x
Volume 60
Issue 4
Start page 429
End page 433
Total pages 5
Editor S. Takahashi
Place of publication Carlton South, Australia
Publisher Blackwell Publishing Asia
Collection year 2006
Language eng
Subject C1
730211 Mental health
321021 Psychiatry
Abstract The aim of this study was to compare the outcomes associated with two differing right unilateral (RUL) electroconvulsive therapy (ECT) dosing protocols: 2-3X seizure threshold (2-3X ST) and fixed high dose (FHD) at 353 mC. A retrospective chart review was performed to compare patient outcomes during the implementation of two different dosing protocols: 2-3X ST from October 2000 to May 2001 and FHD from June 2001 to February 2002. A total of 56 patients received ECT under the 2-3X ST protocol, and 46 received ECT under the FHD protocol. In total, 13.6% of patients receiving ECT according to the 2-3X ST protocol received more than 12 ECT, whereas none of the FHD group received more than 12 ECT. The mean number of ECT per treatment course reduced significantly from 7.6 to 5.7 following the switch from the 2-3X ST protocol to the FHD protocol. There were no significant differences between the two groups in the incidence of adverse cognitive effects. ECT practitioners adhered to the 2-3X ST protocol for only 51.8% of ECT courses, with protocol adherence improving to 87% following introduction of the FHD protocol. Although this naturalistic retrospective chart survey had significant methodological limitations, it found that practitioners are more likely to correctly adhere to a fixed dose protocol, therefore, increasing its 'real world' effectiveness in comparison to titrated suprathreshold dosing techniques. The FHD protocol was associated with shorter courses of ECT than the 2-3X ST protocol, with no significant difference between the two protocols in clinically discernable adverse cognitive effects.
Keyword Clinical Neurology
Neurosciences
Psychiatry
Cognitive Effects
Electroconvulsive Therapy
Fixed High Dose
Threshold
Unilateral Electrode Placement
Stimulus-intensity
Ect
Efficacy
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2007 Higher Education Research Data Collection
School of Medicine Publications
 
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