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THE PROPHYLACTIC VALUE OF EXTRA ECT IN DEPRESSIVE ILLNESS

In the past thirty years, ECT has been widely used to treat depression, but in the extensive literature, there is little agreement about the number of applications required to produce optimal results. There is, however, a strong opinion that patients who appear to respond well to a small number of treatments, are likely to relapse unless additional applications are given. Kalinowsky & Hippius (1969) refer to this practice as “stabilizing the result.” Seager & Bird (1962) are among the authors who have shown that relapse following initial improvement from ECT is common, and Kay et al. (1970) demonstrated that attempts made to prevent such relapse by the administration of antidepressant drugs are far from sure. The practice of giving extra applications of ECT following symptomatic recovery is widely reported in the literature by Hodgson & Sim (1959), Huston & Locher (1948), Ottosson (1962) and Kalinowsky ( 1959). Kalinowsky, whilst advocating this practice, has stressed that the results of the procedure have not been proven to be of value. The purpose of this paper is to investigate the effect on relapse rates of giving additional ECT after full symptomatic relief has been attained.