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Electrode Placement in Electroconvulsive Therapy (ECT): A Review of the Literature

Kellner, Charles H. MD; Tobias, Kristen G. BA; Wiegand, Jessica MD

doi: 10.1097/YCT.0b013e3181e48154
Invited Review

Electrode placement in electroconvulsive therapy affects both the efficacy and adverse cognitive effect profile of the treatment. For many years, 2 placements, bitemporal (also referred to as "bifrontotemporal" or simply "bilateral") and right unilateral, were the principal placements in widespread clinical use. More recently, bifrontal placement has joined their ranks as a commonly used placement. In this article, we review the evidence base for the efficacy and safety of each of these electrode placements for the indication of depression, describe another novel placement, and then draw conclusions from this available evidence base, pointing out areas in need of further study.

From the Mount Sinai School of Medicine, New York, NY.

Received for publication December 30, 2009; accepted March 15, 2010.

Reprints: Charles H. Kellner, MD, The Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1230, New York, NY 10029 (e-mail:

The authors have nothing to disclose.

© 2010 Lippincott Williams & Wilkins, Inc.