Evidence map›Paper›PMID 39759458›Full record

ReviewPCN reports : psychiatry and clinical neurosciences2025

Safety of electroconvulsive therapy in the context of physiological and medical complexity: A state-of-the art review.

Alby Elias, Soumitra Das, James Kirkland, Sarabjit Loyal, Naveen Thomas

Abstract readReview
In one paragraph

Review in PCN reports : psychiatry and clinical neurosciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Alby EliasDepartment of Psychiatry The University of Melbourne Melbourne Victoria Australia.ORCID https://orcid.org/0000-0002-7494-1028
Soumitra DasDepartment of Psychiatry The University of Melbourne Melbourne Victoria Australia.ORCID 0000-0001-7329-8264
James KirklandDivision of Mental Health and Wellbeing Western Health Melbourne Victoria Australia.
Sarabjit LoyalDivision of Mental Health and Wellbeing Western Health Melbourne Victoria Australia.
Naveen ThomasDivision of Mental Health and Wellbeing Western Health Melbourne Victoria Australia.ORCID https://orcid.org/0000-0001-6876-1015

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Medical contraindications and complications pose challenges for electroconvulsive therapy (ECT). Most published reports are scattered across various physiological systems and individual disease conditions. This review aimed to evaluate the literature on physiological and medical complexities during ECT and discuss risk mitigation strategies in a comprehensive review. We searched PubMed and Embase for contraindications and precautions during ECT with relevant MeSH terms and appraised previous reviews on the same topic. The results suggest that mortality directly attributed to ECT is extremely rare. Instances of fatalities, including fetal deaths, have been reported after ECT in the presence of recent myocardial infarction, deep vein thrombosis, intracranial aneurysm and tumors, pheochromocytoma, sepsis, and pregnancy. However, there are no definite conclusions or consensus on attributions of the outcomes to ECT in all cases because of the time lag between the treatment and deaths and confounding factors. The risks can be mitigated with safety protocols, adequate stakeholder communication, collaboration with anesthetists and specialists, consultation-liaison services, and ECT education. Overall, ECT remains a relatively safe treatment even in the presence of medical and physiological complexities. In rare instances, certain medical conditions may indicate a high risk for ECT, where practitioners avoid the treatment or administer it with precautions if the risk-benefit ratio favors its use.

Indexed as

ECTelectroconvulsive therapymedical complicationprecautionrisk

Identifiers

PMID39759458
PMCPMC11695668

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.