Bilateral versus unilateral electroconvulsive therapy: efficacy in melancholia

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Abstract
The therapeutic efficacy of bilateral and unilateral electroconvulsive therapy (ECT) in 51 patients with endogenous depression who were randomly assigned to bilateral (N = 24) or unilateral (N = 27) ECT. Seizures were monitored by oscilloscope. After 6 treatments, blind assessment on a modified Hamilton depression scale showed an 81.1% improvement in the bilateral group compared with a 55.5% improvement in the unilateral group. Additional treatments were prescribed ad lib by a hospital psychiatrist who was unaware of each patient''s electrode placement. The unilateral group received more total treatments and were more frequently switched to bilateral ECT. These results were independent of age, severity of illness or sedative drug administration.