Maintenance ECT: Why Some People Need Continuation ECT

Electroconvulsive therapy, once known as shock therapy, is a safe and effective treatment for depression and other mental illnesses. Electroconvulsive therapy (ECT) is most often used in cases of severe, intractable, hard to treat (treatment-resistant) depression. Generally, ECT is a short-term treatment where the patient receives 6-12 treatments over the course of 2-4 weeks.

However, in some cases, continuation ECT or maintenance ECT is used. These two therapies continue ECT beyond the initial 6-12 sessions used in acute treatment. This initial acute treatment is known as an "index series" or a "course" of ECT.

Continuation ECT

Relapse after a positive response to ECT is common. Most frequently, prevention of relapse is accomplished through the use of medication but continuation ECT has also been shown effective for the prevention of illness relapse.

Continuation ECT is electroconvulsive therapy continued for approximately the six months following the initial index series.¹ Continuation ECT involves a treatment once every 1-6 weeks.² Continuation ECT is typically used for patients who have initially positively responded to ECT and can give informed consent for its further use. Often those who do not respond to medication choose continuation ECT.

Maintenance ECT

Maintenance ECT consists of ECT treatments given infrequently over a long period of time after the index series and continuation ECT. The goal of maintenance ECT is to prevent the reoccurrence of the mental illness.

Maintenance ECT may be given for months or even years with approximately one ECT treatment every three weeks.³ Maintenance ECT has been shown safe and effective in preventing illness reoccurrence. When maintenance ECT is combined with psychiatric medication treatment, it appears to be more effective than either medication or maintenance ECT alone.⁴

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