Background: To assess the incidence of depressed inpatients requiring high output ECT and the response of this group compared with a group requiring standard output ECT. Methods: We reviewed the records of 59 consecutive inpatients that were treated with bilateral ECT between January 2001 and January 2004. Diagnosis of major depression was based on DSM IV criteria. Response and remission to ECT (respectively defined as a 50% reduction in score and a score of ≤ 7 on the Hamilton Rating Scale for Depression; HRSD) of both groups were compared. Results: Of the 59 patients, 13 (22%) required high output ECT. These patients needed significantly more ECT treatments than patients in the standard dose group (16.4 ± 7.1 versus 10.4 ± 4.5; p = 0.01). In total, 31 of 46 patients (67%) requiring standard output ECT and 11 of the 13 patients (85%) requiring high output ECT responded to ECT. This difference is not significant. Limitations: This study has a retrospective nature and a rather homogenous sample. Conclusion: In this study 1 in 5 of the depressed inpatients needs a high dose energy of bilateral ECT to induce an adequate seizure. The efficacy of ECT in these patients is similar to that in the standard dose group. Considering these facts, high output ECT devices should be available for use in routine clinical practice.

Depressive disorder, ECT device, Electroconvulsive therapy, Output limitations, Seizure threshold,
Journal of Affective Disorders
Department of Psychiatry

Ju, M.R, Birkenhäger, T.K, & van den Broek, W.W. (2005). Does power matter with ECT?. Journal of Affective Disorders (Vol. 89, pp. 213–216). doi:10.1016/j.jad.2005.09.005