SynthesisEuropean archives of psychiatry and clinical neuroscience2009
Meta-analysis of initial seizure thresholds in electroconvulsive therapy.
Synthesis in European archives of psychiatry and clinical neuroscience, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Approaches for difficult-to-induce-seizures electroconvulsive therapy cases (DEC): a Japanese expert consensus.Annals of general psychiatry · 2025Article
- Effectiveness of magnetic seizure therapy versus electroconvulsive therapy for major depressive episode in China: protocol for a double-blind, randomized, non-inferiority trial.Frontiers in psychiatry · 2025Article
- Ictal Electroencephalogram Visual Pattern Recognition of Seizure Adequacy During Electroconvulsive Therapy Treatment: A Step-by-Step Approach.The Malaysian journal of medical sciences : MJMS · 2023Article
- Parsing the Network Mechanisms of Electroconvulsive Therapy.Biological psychiatry · 2022Review
- Rate of continuing acute course treatment using right unilateral ultrabrief pulse electroconvulsive therapy at a large academic medical center.European archives of psychiatry and clinical neuroscience · 2021Article
- Can Propofol Lead to an Increase in Seizure Threshold Over the Course of Electroconvulsive Therapy?Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2019Article
- Initial Seizure Threshold in Brief-Pulse Bilateral Electroconvulsive Therapy in Patients with Schizophrenia or Schizoaffective Disorder.Psychiatry investigation · 2019Article
- Stimulus intensity determined by dose-titration versus age-based methods in electroconvulsive therapy in Thai patients.Neuropsychiatric disease and treatment · 2019Article
- S -ketamine compared to etomidate during electroconvulsive therapy in major depression.European archives of psychiatry and clinical neuroscience · 2017Article
- Effects of stimulus parameters on motor seizure duration in electroconvulsive therapy.Neuropsychiatric disease and treatment · 2017Article
- Clinical predictors of seizure threshold in electroconvulsive therapy: a prospective study.European archives of psychiatry and clinical neuroscience · 2013Article
- Electroconvulsive therapy for treating schizophrenia: a chart review of patients from two catchment areas.European archives of psychiatry and clinical neuroscience · 2011Article
- Charge required to induce a seizure during initial dose titration using right unilateral brief pulse electroconvulsive therapy.Brain stimulationArticle
- Effect of age and anticonvulsants on seizure threshold during bilateral electroconvulsive therapy with brief-pulse stimulus: A chart-based analysis.Indian journal of psychiatryArticle
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In electroconvulsive therapy (ECT), electrical dosage is determined using 'fixed-dose', 'age-based' dose, or empirical titration methods. Estimation of initial seizure threshold (IST) has been claimed to be imperative for suprathreshold dosing. This systematic review aimed to determine common levels of IST, to define cut-off values for high IST, and to summarize reported IST associated factors. Medline and PsycINFO were searched from 1966 to January 2008 and relevant references were cross-checked. Subject headings including ECT, seizure threshold, dosage, and dosing were used. All articles reporting on levels of IST and/or associated factors were included. Of 395 potentially relevant reports, 46 studies on 70 samples concerning 3,023 patients were selected. Nine samples (n = 306 patients) without available standard deviation and four samples (n = 275 patients) treated with mixed electrode placement were excluded. Meta-analysis was done on 30 unilaterally treated samples (n = 1,326 patients) and 27 bilaterally treated samples (n = 1,116 patients). In unilateral ECT, weighted mean of IST was 68.2 milliCoulombs (mC; 95% CI 63.2-73.3 mC), and in bilateral ECT 111.6 mC (95% CI 103.7-119.4 mC). Calculated cut-off values for high IST were 121 mC for unilateral ECT and 221 mC for bilateral ECT. According to the literature, male gender and use of bilateral electrode placement appeared to increase IST most prominently. In conclusion, calculated electrical doses for 'suprathreshold' right unilateral ECT and for 'moderate above threshold' bilateral ECT, using commonly reported IST levels, were in the same though narrower ranges as provided in 'fixed-dose' and 'half-age' based strategies, respectively.
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