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Electrode Placement and Electroconvulsive Therapy: A Search for the Chimera
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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To achieve an adequate antidepressant effect with right unilateral (RUL)
electrode placement ECT, equivalent to that of bilateral (BL) electrode placement,
the authors of 2 reports find it necessary to increase the stimulating energy
at least 5-fold above the seizure threshold (ST).1, 2
They recommend that ECT now be done with unilateral electrode placement after
first determining the ST and delivering subsequent treatments with energies
at 6 x ST. The authors see their findings as resolving a 30-year controversy.
The discussant, Richard Abrams, MD, agrees and reminds us that to achieve
the benefits of this modification in practice, we need relief from arbitrary
Food and Drug Administration (FDA) rulings that artificially limit the energy
output of US ECT devices.
We are not persuaded that the data in these reports justify the conclusion
of equivalence in efficacy of RUL (d'Elia) placement at 6 x ST with
a saving in memory effects over . . . [Full Text of this Article]
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