Efficacy and prediction of response

About 80 per cent of severe depressive episodes respond well to ECT in the short term. Features predicting a good response - which are essentially markers of a severe depressive illness in a previously healthy person - include retardation, guilt, delusions, early morning waking, symptoms worse in the mornings, short duration of illness, and stable premorbid personality.

Milder depression tends not to respond well, especially if mixed with neurotic symptoms and poorly adjusted premorbid personality, and ECT would not now be used in this situation.

About two-thirds of patients given ECT for depression will relapse within 6 months unless given maintenance treatment with an antidepressant drug or lithium.

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