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Research Article| Volume 20, ISSUE 5, P506-514, May 1985

Missed and brief seizures during ECT: Differential response between unilateral and bilateral electrode placement

DOI:https://doi.org/10.1016/0006-3223(85)90022-8
Missed and brief seizures during ECT: Differential response between unilateral and bilateral electrode placement
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      Abstract

      The number of electroconvulsive therapy (ECT) stimulations over a course of treatment that resulted in brief or no seizure activity was evaluated for depressed patients (N = 58, treated for DSM-III diagnosed major depressive disorder) who had been randomly assigned to either bilateral or unilateral nondominant ECT in a double-blind study. Comparable treatment efficacy between both groups was found. Although there were no group differences in brief seizures, unilateral nondominant ECT resulted in more missed seizures (p < 0.01) and required more restimulations than bilateral ECT. Of 27 unilateral ECT patients, 63% had at least one missed seizure over the course of treatment, compared to 29% of 31 bilateral ECT patients (p < 0.02). Although more missed seizures occurred early in treatment, brief seizures occurred later in treatment. As missed seizures are not always detected clinically, it is possible that without seizure monitoring patients with unilateral nondominant ECT will not improve at the same rate as patients with bilateral ECT. Lack of seizure monitoring in the clinic is one likely explanation for the discrepancy between a number of research studies reporting equivalent efficacy for bilateral and unilateral ECT and the clinical impression that bilateral ECT is more effective.
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      Article info

      Publication history

      Received in revised form: November 5, 1984
      Received: August 17, 1984

      Footnotes

      ☆Abridged version of a paper that received honorable mention for the 1984 A. E. Bennett Award.

      ☆☆Supported by the Carrier Foundation.

      Identification

      DOI: https://doi.org/10.1016/0006-3223(85)90022-8

      Copyright

      © 1985 Published by Elsevier Inc.

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