• Anaesthetic contraindications include severe respiratory or cardiac disease.

• Another contraindication is organic brain disease of a kind in which increased cerebral blood flow would be dangerous, such as cerebral aneurysm, or conditions involving raised intracranial pressure. Other forms of organic brain disease, including dementia, epilepsy, and a past history of head injury, do not necessarily rule out the use of ECT, but do carry an increased risk of confusion after treatment.

These contraindications are relative, not absolute, and may need to be balanced against the risk to life posed by severe depression when deciding whether ECT is justified. Pregnancy is not a contraindication, nor is old age.

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