OBJECTIVE: Maintenance electroconvulsive therapy (maintenance ECT) has
emerged as an alternative treatment for patients who relapse repeatedly or
cannot tolerate psychotropic medications. The pattern of maintenance ECT
use in two university-affiliated hospitals was surveyed to evaluate its
effectiveness in treating several disorders, establish treatment
guidelines, and identify adverse side effects. METHODS: Records of 161
patients who received ECT from 1976 through 1988 were reviewed
retrospectively. Nine patients who received maintenance ECT-- prophylactic
ECT treatments administered for longer than six months-- were identified.
The presence of target symptoms and behaviors in the periods before and
after administration of maintenance ECT was compared. RESULTS: All nine
patients experienced a complete or a significant partial remission of
target symptoms. Six of the nine patients were ready for transfer to less
restrictive settings. Given the small number of patients, treatment
guidelines could not be established; however, patients with mood disorder
required less frequent treatments than patients with thought disorder.
Adverse effects were documented for two of the nine patients, but they were
not severe enough to discontinue treatment. CONCLUSIONS: For this sample,
maintenance ECT was a safe, efficacious, and well-tolerated treatment with
minimal side effects. Further, controlled studies are warranted.