Next Generation Seizure Therapy

Abstract

Abstract Electroconvulsive therapy (ECT) is highly effective in treating severe psychiatric conditions, but its cognitive side effects have been a limiting factor in its clinical use. Fortunately, decades of research have led to improvements in ECT technique that have improved its risk:benefit ratio. Insights derived from the relationships among treatment technique (including electrode placement, pulse width, and other parameters of stimulation) and clinical outcomes (such as antidepressant efficacy and adverse cognitive side effects) have advanced scientific understanding regarding the roles of the induced electric field and resultant changes in brain structure and function. These insights have paved the way for the next generation of seizure therapy devices which seek to further enhance the safety and efficacy of ECT, including more focal electrode configurations and magnetic seizure induction. This chapter reviews the latest developments in the modernization of the oldest somatic therapy still in use in psychiatry today, and highlights areas for future development.