Therapy resistance, relapsing illness, and rapid cycling are aspects of chronic affective illness that continue to frustrate us. ECT was re-introduced to answer the problem of therapy resistant depression. In their recent review, Matzen et al. (I), report their experience in eight cases treated with maintenance ECT. They argue that maintenance ECT should also be considered for relapsing depressive illness.
No systematic study of maintenance ECT has been undertaken since the early I950s, and yet, as reported by Kramer (2) it continues to be used. Kramer directed inquiries to members of the International Association for the Advancement of Electrotherapy. Of 86 respondents, 51 reported they used maintenance treatments in 1986. Usage was small, however, approximately three patients per practitioner in a year. Despite the lack of experimentally derived guidelines, the procedures were relatively uniform. After an illness had responded to a course of ECT, treatments were given at weekly intervals, followed after a few weeks by bi-weekly, then monthly treatments. The treatment practice described by Matzen et al. are similar.
Fink, MD, Max
"In Response: Maintenance ECT,"
Jefferson Journal of Psychiatry:
1, Article 11.
Available at: http://jdc.jefferson.edu/jeffjpsychiatry/vol7/iss1/11