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Use of Continuation and Maintenance Electroconvulsive Therapy: UK National Trends

Gupta, Susham MBBS, MRCPsych*; Hood, Chloë BA(Hons); Chaplin, Robert MBBS, MRCPsych‡§

doi: 10.1097/YCT.0b013e3181de3314
Original Studies

Background: Continuation and maintenance electroconvulsive therapy (ECT) have been used for prophylactic treatment of recurrent depression but are poorly researched and not recommended by the National Institute of Health and Clinical Excellence, UK.

Aims: To document the demographic, clinical, and legal characteristics of patients receiving continuation or maintenance ECT, trends in their use, and whether the 2 types could be distinguished by duration and frequency of application.

Method: Electroconvulsive therapy specialist psychiatrists completed postal questionnaires about its current use and retrospective use over the past decade.

Results: Thirty-five (34%) clinics responded, with 26% currently treating patients with either treatment. Its use has declined over a 5-year period after restrictive guidance by the National Institute for Clinic Excellence. The mean age of patients was 60 years, and more women are treated. Maintenance ECT was given for a longer duration and less frequently than continuation ECT.

Conclusions: Use has declined since 2001-2002. Continuation and maintenance ECT can be differentiated according to the frequency and duration of treatment.

From the *East London NHS Foundation Trust; †ECT Accreditation Service (ECTAS); ‡Research Unit, Royal College of Psychiatrists; and §Oxfordshire and Buckinghamshire Foundation Trust, UK.

Received for publication August 17, 2009; accepted January 27, 2010.

Reprints: Susham Gupta, MBBS, MRCPsych, East London NHS Foundation Trust, Hackney, London, UK (e-mail:

The authors have no conflicts of interest.

© 2011 Lippincott Williams & Wilkins, Inc.