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The Practice of Electroconvulsive Therapy in Asia: Variations and Deviations From the Guidelines-A Response to Dr Grunhaus

Andrade, Chittaranjan MD*; Chanpattana, Worrawat MD†; Kramer, Barry A. MD‡; Kunigiri, Girish MD§; Gangadhar, Bangalore N. MD∥; Kitphati, Rungrueng MD¶

Journal of ECT:
doi: 10.1097/YCT.0b013e3181d03773

Electroconvulsive therapy (ECT) is widely used in most countries in Asia. There are several regards in which the practice of ECT in this region deviate from the guidelines issued by the American Psychiatric Association and the Royal College of Psychiatrists. The deviations are a matter of concern but are not surprising, considering that most previous surveys have also documented deviations from these guidelines. We are trying to explain all probable causes of this suboptimal practice, and then, we recommend how to improve the practice of ECT in Asian countries.

Author Information

From the *Department of Pharmacology, National Institute of Mental Health and Neurosciences, Bangalore, India; †Department of Psychiatry, Samitivej Srinakarin Hospital, Bangkok, Thailand; ‡Department of Psychiatry, Cedars Sinai Medical Center, Los Angeles, CA; §Bradgate Mental Health Unit, Glenfield Hospital, Leicester, UK; ∥Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India and ¶Department of Medical Sciences, National Institutes of Health, Ministry of Public Health, Nonthaburi, Thailand.

Received for publication November 12, 2009; accepted November 18, 2009.

The authors have no conflicts of interest to declare.

Reprints: Worrawat Chanpattana, MD, Department of Psychiatry, Samitivej Srinakarin Hospital, 488 Srinakarin Rd., Suanluang, Bangkok 10250, Thailand (e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.