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Need to Titrate in Ultrabrief Electroconvulsive Therapy—Need for More Evidence

Suetani, Shuichi BSc, MB ChB; Waite, Susan BMMB, RANZCP

doi: 10.1097/YCT.10.1097/YCT.0b013e3182a27088
Brief Clinical Report Letters

A recent audit on ultrabrief electroconvulsive therapy (ECT) at our hospital revealed that most of the patients had an increase in seizure threshold during their routine dose retitration at session 7. These patients subsequently received an increased dose to sustain a therapeutic dose of 6 times the seizure threshold. Our results raise the possibility that patients may be receiving inadequate doses before retitration in the setting of rising seizure thresholds, thus potentially affecting the efficacy of ultrabrief ECT. Further studies are needed to provide more insight into the need for retitration and in determining the optimal therapeutic dose in ultrabrief ECT.

From the Queen Elizabeth Hospital, Adelaide, South Australia.

Received for publication June 12, 2013; accepted June 13, 2013.

Reprints: Shuichi Suetani, BSc, MB ChB, The Queen Elizabeth Hospital, Adelaide, South Australia (e-mail:

The authors declare no conflict of interest or financial disclosures to report.

© 2014 by Lippincott Williams & Wilkins