College guidelines on electroconvulsive therapy: an update for prescribers

Abstract

This article is intended to update prescribers of electroconvulsive therapy (ECT) on the key points of the revised edition of the Royal College of Psychiatrist's ECT Handbook (due to be published in 2005). The two most important tenets that influenced the revision were that evidence from systematic reviews and appraisals was balanced with expert judgement based on clinical experience, and that both prescribers and practitioners should strive to reduce further the cognitive adverse effects of treatment. The article concentrates on revised guidance regarding the indications for ECT, important elements of the process of informed consent, and the prescription of treatment, i.e. choice of electrode placement and the frequency and total number of treatments.