What is continuation electroconvulsive therapy (ECT)?

Updated: Sep 24, 2019
  • Author: Mehul V Mankad, MD; Chief Editor: Dennis M Popeo, MD  more...
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Answer

Continuation ECT is used for prevention of relapse. [51]  Because of the high risk of relapse after ECT, especially during the first few months, the argument for aggressive continuation therapy is compelling. [1]  The term Continuation ECT is often used to describe less frequent treatments delivered in the months immediately following a successful index course of ECT. Maintenance ECT is sometimes used as the term for less frequent treatments delivered several months after an index course of ECT. These terms are often combined under the rubric of maintenance ECT.

Indications for maintenance ECT include a history of ECT-responsive illness, patient preference, resistance or intolerance to medications alone, and ability of the patient (or surrogate consenter) to provide informed consent and adhere to the treatment plan. [1]

Maintenance ECT is often combined with medication therapy as well. Combined trials of pharmacotherapy and maintenance ECT have included nortriptyline, lithium, and venlafaxine. Results from these studies are mixed. Some data suggests that the combination of ECT and maintenace medication is superior to medication alone. Other data suggest that the two approaches are equal. [90, 91, 23]


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