Electroconvulsive therapy in 1985 — a review

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Abstract
Electroconvulsive therapy (ECT) has recently been re‐examined in randomized, double‐blind controlled trials. Although a variable placebo influence has been demonstrated, the effectiveness of ECT in severe depression is now well established. ECT may also have a role in the treatment of resistant schizophrenia. A bilateral convulsion is essential for therapeutic efficiency. Unilateral electrode placement is as effective as bilateral placement and reduces subsequent memory impairment considerably. A reduction in the total electrical energy used to produce the convulsion (with unidirectional squared wave forms and brief pulses) lessens cognitive difficulties after ECT. Long‐term memory is not impaired but selective impairment of verbal and non‐verbal learning can occur in the short term. Psycho‐pharmacological studies suggest that postsynaptic dopamine transmission may be enhanced by ECT.