A protocol to augment ECT seizure duration

Abstract

The presence of a generalised seizure is necessary, although not sufficient, for effective ECT. Awareness of this has led to a widespread practice of documenting not only the occurrence but also the duration of seizures; a minimum duration of 25 seconds has been suggested (Royal College of Psychiatrists, 1989). Yet even the most recent surveys of practice have shown that on most occasions when a seizure is brief or absent the treating doctor does nothing about it (Scott et al, 1989; Pippard, 1992).