The comparative effectiveness of fixed and stimulus dosing forms of electroconvulsive therapy for the treatment of unipolar depression: A ‘quality assurance’ study

Abstract

While the necessity for suprathreshold dosing has become widely accepted as the most effective means of administering ECT, there are differing schools of thought regarding the utilisation of this approach in day-to-day clinical practice. Abrams [] and Fink [] support fixed dosing whereby patients receive a fixed dose of about 2.5 times the average population seizure threshold (approximately 375–500 mC). On the other hand, Sackeim [] developed the technique of stimulus dosing with which individual seizure thresholds and suprathreshold doses are determined. Both the American, and Australian and New Zealand Psychiatric Associations [] view both fixed and stimulus dosing in ECT as appropriate and acceptable alternatives. This has also been endorsed in recent literature [].