REASONS FOR DISCONTINUING ECT

During the audit in Scotland a record was kept of the reasons why a course of treatment was not completed as planned.

• The overall rate for treatment being stopped early was 6.7%, half of these were because the patient withdrew consent.
• The overall side-effect rate leading to the stopping of treatment was 4.1%.This is much less than the quoted rate in some studies (18-35% in one elderly population). In comparison the discontinuation of antidepressant drugs due to side-effects is reported at 28-31%.
• Out of the 1314 courses of ECT given, a significant medical problem was reported in 8 (0.6%) and an anaesthetic problemin 4 (0.3%) of cases.These rates are low compared to those in the literature.
• Two elderly patients died within one week of the ECT being discontinued. Both patients were known to suffer from coronary heart disease and were given ECT in an attempt to treat a life threatening depressive illness. Other audits of follow up after ECT have reported a similar finding.
• One patient committed suicide having initially responded to treatment.
• Acute confusion leading to stopping treatment was recorded in just over 1% of patients.This is much lower than the 10.8% rate quoted in the literature.