Electroconvulsive therapy professional practice guideline

Key practice points

The PPG provides practical guidance for psychiatrists prescribing and administering electroconvulsive therapy (ECT).

• ECT is an effective treatment with a strong evidence base for a number of major depressive disorders and other psychiatric disorders, such as bipolar disorder and acute and chronic treatment-resistant schizophrenia.
• The overall purpose of the PPG is to encourage ECT practice that minimises adverse effects and improves outcomes for patients. Psychiatrists are encouraged to consider the relative benefits and risks of the various ECT techniques, with acknowledgement that there is a range of valid treatment approaches which need to be individualised to the patient.
• Key practice considerations are: the combination of dosing, electrode placement, pulse width, session frequency, concomitant medication and anaesthetic approach.
• Specific considerations are required when using ECT in the treatment of children and adolescents, pregnant women, and people with comorbid medical issues.
• It is important to consider legislation, patient selection, consent, education and training, research and governance, as well as the clinical aspects relevant to ECT administration.

Community resources

Electroconvulsive therapy - position statement