What the study found
The authors describe substantial variability in seizure adequacy and later charge adjustments during electroconvulsive therapy, or ECT, across five Danish adult psychiatric departments. They also state that current dosing practices likely help prevent inadequate dosing and are associated with the reported 50% to 70% reductions in Hamilton Depression Rating Scale scores, a standard measure of depression severity.
Why the authors say this matters
The authors suggest that efforts to reduce cognitive side effects should not weaken ECT’s effectiveness. They also argue that more technical and physiological rigor, including modeling of electric fields, individualized dosing, and improved targeting, is justified rather than being treated as misplaced perfectionism.
What the researchers tested
The article discusses Jorgensen et al.’s assessment of technical and clinical ECT variables using electronic health records from five Danish adult psychiatric departments. The departments followed national guidelines using a Thymatron System IV, bitemporal electrode placement at initiation, age-based dosing, and dose escalation when seizure adequacy was insufficient.
What worked and what didn't
The authors say bitemporal electrode placement, 900 mA current, brief pulse width, and the '2X dose' program likely contributed to the observed depression-score reductions and helped avoid underdosing. They also say these parameters do not protect against excessive dosing, and that the investigation lacked reliably recorded cognitive data.
What to keep in mind
The abstract says cognitive outcomes were not reliably recorded, so the study cannot address cognitive side effects well. It also notes that current practice still relies on qualitative seizure judgments, that the field lacks definitive seizure metrics and a precise anatomic or network target for optimal electrode placement, and that some newer approaches are promising but not yet ready for widespread clinical adoption.
Key points
- Five Danish adult psychiatric departments were reviewed using electronic health records.
- The departments followed national ECT guidelines with bitemporal initiation and age-based dosing.
- The authors report variability in seizure adequacy and charge adjustments across the ECT course.
- They say the dosing approach likely contributed to 50% to 70% reductions in Hamilton Depression Rating Scale scores.
- The abstract notes that cognitive data were not reliably recorded.
- The authors describe newer individualized and model-based ECT approaches as promising but not yet ready for widespread use.
Disclosure
- Research title:
- ECT dosing practices vary, but efficacy remains strong
- Authors:
- Chris Abbott, Abhishek Datta, Zhi-De Deng
- Institutions:
- City College of New York, National Institute of Mental Health, National Institute of Mental Health, Soterix Medical (United States), University of New Mexico
- Publication date:
- 2026-04-03
- OpenAlex record:
- View
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