Stimulus dosing

Research output: Chapter in Book/Report/Conference proceedingChapter

8 Scopus citations

Abstract

Decision making regarding the choice of stimulus dose for a session of electroconvulsive therapy (ECT) has become increasingly complicated, making it difficult to make specific recommendations in selecting a stimulus dose. Variability in ECT provider awareness of new data, and differences between early adopters and late adopters of new information, will add to the already great variability in the practice of ECT, at least in the short term (Prudic et al., 2004). Still, some general recommendations can be made, and these are presented at the end of this chapter. Unless stated otherwise, all comments in this chapter pertain to the acute treatment of depressive disorders. Questions about the proper management of the electrical stimulus have been central to the science and practice of ECT since the inception of the treatment. Problems in stimulus dosing include (a) whether the stimulus should be subconvulsive or convulsive; (b) defining the optimal stimulus waveform; (c) if a convulsive stimulus is desired, to what degree should the stimulus intensity be in excess of the convulsive threshold; and (d) which physiological parameters, if any, provide useful feedback to continuously refine stimulus dosing throughout the ECT course.

Original languageEnglish (US)
Title of host publicationElectroconvulsive and Neuromodulation Therapies
PublisherCambridge University Press
Pages447-467
Number of pages21
ISBN (Electronic)9780511576393
ISBN (Print)9780521883887
DOIs
StatePublished - Jan 1 2009
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    McCall, W. V. (2009). Stimulus dosing. In Electroconvulsive and Neuromodulation Therapies (pp. 447-467). Cambridge University Press. https://doi.org/10.1017/CBO9780511576393.029