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New ECT guidelines help psychiatrists to improve patient outcomes

11 April 2019

The RANZCP has published new Professional Practice Guidelines (PPG) to provide practical guidance for psychiatrists prescribing and administering electroconvulsive therapy (ECT).

ETC is an effective treatment with a strong evidence base for a number of major depressive disorders and other psychiatric disorders, such as bipolar disorder and acute and chronic treatment-resistant schizophrenia.

The overall purpose of the guidelines is to encourage ECT practice that minimises adverse effects and improves outcomes for patients.

The guidelines also provide advice on the use of ECT in the treatment of children and adolescents, pregnant women, and people with comorbid medical issues.

A main focus of the guidelines is on the relative benefits and risks of the various ECT techniques, with acknowledgement that there is a range of valid treatment approaches which need to be individualised to the patient.

Of key consideration is the combination of dosing, electrode placement, pulse width, session frequency, concomitant medication and anaesthetic approach.

An overall review of legislation, patient selection, consent, education and training, research and governance is provided, as well as the clinical aspects relevant to ECT administration

The PPG is available in the Australian and New Zealand Journal of Psychiatry (ANZJP) [member log-in required].

The significant work of the Section of Electroconvulsive Therapy and Neurostimulation Working Group is acknowledged: Dr Alan Weiss, Dr Salam Hussain, Dr Bradley Ng, Dr Shanthi Sarma, Professor John Tiller, Dr Susan Waite and Professor Colleen Loo.