ABSTRACT

Electroconvulsive therapy (ECT) has been in use for psychiatric disorders since 1938 and is used virtually around the world [1]. Arguably, it may be considered the single most important intervention, on a global basis, for severe states of mental illness because of the lack of readily available psychotropic medications in impoverished areas. ECT is an important treatment in modern psychiatry. It is estimated that ∼100,000 patients a year in the United States are given ECT [1]. The majority of these patients suffer from major depression, which according to WHO estimates will be the second leading cause of disability by 2020 [2]. Research publications emanate from all populated continents. Herewith, I shall brie°y describe ECT to familiarize the reader with the indications, apparatus, and treatment techniques. Then I will discuss the various considerations in designing scienti cally rigorous trials.