Re-evaluating the effectiveness of ultrabrief pulse ECT: the potential role of (In)appropriate seizure threshold titration

Jelovac A, McLoughlin DM. Ultrabrief pulse electroconvulsive therapy for depression: a systematic review and meta-analysis. Mol Psychiatry. 2026;31:1132–41.

Article  PubMed  Google Scholar 

Sackeim H, Decina P, Prohovnik I, Malitz S. Seizure threshold in electroconvulsive therapy: effects of sex, age, electrode placement, and number of treatments. Arch Gen Psychiatry. 1987;44:355–60.

Article  CAS  PubMed  Google Scholar 

Sackeim HA, Prudic J, Nobler MS, Fitzsimons L, Lisanby SH, Payne N, et al. Effects of pulse width and electrode placement on the efficacy and cognitive effects of electroconvulsive therapy. Brain Stimul. 2008;1:71–83.

Article  PubMed  PubMed Central  Google Scholar 

Spaans HP, Verwijk E, Comijs HC, Kok RM, Sienaert P, Bouckaert F, et al. Efficacy and cognitive side effects after brief pulse and ultrabrief pulse right unilateral electroconvulsive therapy for major depression: a randomized, double-blind, controlled study. J Clin Psychiatry. 2013;74:e1029–e1036.

Article  PubMed  Google Scholar 

Kellner CH, Husain MM, Knapp RG, McCall WV, Petrides G, Rudorfer MV, et al. Right unilateral ultrabrief pulse ECT in geriatric depression: phase 1 of the PRIDE study. Am J Psychiatry. 2016;173:1101–9.

Article  PubMed  PubMed Central  Google Scholar 

van Waarde JA, van Oudheusden LJB, Heslinga OB, Verwey B, van der Mast RC, Giltay E. Patient, treatment, and anatomical predictors of outcome in electroconvulsive therapy: a prospective study. J ECT. 2013;29:113–21.

Article  PubMed  Google Scholar 

Meijer J, Hoogendoorn A, Mocking R, van Eijndhoven P, Berkhof N, Hegeman JM, et al. Impact of titration, dosing-factor and pulse-width on electroconvulsive therapy remission rates in depression. Brain Stimul. 2025;18:548.

Article  Google Scholar 

Sackeim HA, Prudic J, Devanand DP, Nobler MS, Lisanby SH, Peyser S, et al. A prospective, randomized, double-blind comparison of bilateral and right unilateral electroconvulsive therapy at different stimulus intensities. Arch Gen Psychiatry. 2000;57:425–34.

Article  CAS  PubMed  Google Scholar 

McCall WV, Reboussin DM, Weiner RD, Sackeim HA. Titrated moderately suprathreshold vs fixed high-dose right unilateral electroconvulsive therapy: acute antidepressant and cognitive effects. Arch Gen Psychiatry. 2000;57:438–44.

Article  CAS  PubMed  Google Scholar 

Jażdżyk P, Kuc A, Stachura A, Segiet-Święcicka A, Kosmalski M, Święcicki Ł, et al. Comparison of high-charge protocol vs dose titration protocol in bilateral ECT: evaluation of antidepressant effectiveness and EEG parameters. J Clin Med. 2025;14:6490.

Article  PubMed  PubMed Central  Google Scholar 

Mayur P, Byth K, Harris A. Acute antidepressant effects of right unilateral ultra-brief ECT: a double-blind randomised controlled trial. J Affect Disord. 2013;149:426–9.

Article  PubMed  Google Scholar 

Comments (0)

No login
gif