Original StudiesDuration of Treatment in Electroconvulsive Therapy Among Patients Beginning With Acute Course Right Unilateral Brief Pulse StimuliLuccarelli, James MD, DPhil∗,†,‡; McCoy, Thomas H. Jr MD∗,‡; Shannon, Alec P. BS∗; Forester, Brent P. MD, MSc‡,§; Seiner, Stephen J. MD†,‡; Henry, Michael E. MD∗,‡ Author Information From the ∗Department of Psychiatry, Massachusetts General Hospital, Boston †Department of Psychiatry, McLean Hospital, Belmont ‡Harvard Medical School, Boston §Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA. Received for publication August 31, 2020; accepted January 30, 2021. Reprints: James Luccarelli, MD, DPhil, Massachusetts General Hospital, 32 Fruit Street, Yawkey 6A, Boston, MA 02114 (e-mail: [email protected]). T.H.M. receives research funding from the Stanley Center at the Broad Institute, the Brain and Behavior Research Foundation, National Institute of Mental Health, National Human Genome Research Institute Home, and Telefonica Alfa. Dr Forester receives research support from the National Institute on Aging, Biogen, Lilly, the Rogers Family Foundation, and the Spier Family Foundation. He reports consulting for Biogen. The remaining authors have no conflicts of interest or financial disclosures to report. This work was supported by the National Institute of Mental Health (R25MH094612, to J.L.; R56MH115187 and R01MH120991, to T.H.M.; and 5R01MH112737-03, to M.E.H.), the National Institute on Aging (5R01AG061100-02, to B.P.F.), and the Brain and Behavior Research Foundation (NARSAD 26489, to T.H.M.). The sponsors had no role in the study design, writing of the report, or data collection, analysis, or interpretation. Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.ectjournal.com). The Journal of ECT: December 2021 - Volume 37 - Issue 4 - p 238-242 doi: 10.1097/YCT.0000000000000768 Buy SDC Metrics Abstract Objectives Right unilateral brief pulse (RUL-BP) electroconvulsive therapy (ECT) has been adopted as a technique for reducing the cognitive side effects of ECT relative to sine wave or bilateral treatments, but it is unknown how often patients are transitioned to alternative electrode placements. This study analyzes time in first lifetime acute course RUL-BP ECT. Methods A single-center retrospective chart review was conducted of adult patients receiving a first lifetime course of ECT from 2000 to 2017 beginning with individualized seizure threshold determination using RUL-BP treatment parameters. Results A total of 1383 patients met study criteria and received a mean number of 9.4 ± 3.1 treatments, of which 7.6 ± 3.3 were using RUL-BP stimuli. Only 37.5% of patients were transitioned from RUL to bilateral treatments. Younger patients and those diagnosed with bipolar disorder were more likely to transition from RUL-BP to bilateral treatments, but the overall number of treatments did not differ based on age or primary diagnosis. Conclusions Among patients who begin treatment with RUL-BP ECT, more than 60% use exclusively those parameters throughout their acute course. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.