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Year : 2022  |  Volume : 10  |  Issue : 1  |  Page : 19-23

Indications and prescription pattern of electroconvulsive therapy: A 5-year retrospective medical record review of inpatients in a Tertiary Care Center

1 Consultant Psychiatrist, Serenity Clinic, Delhi, India
2 Department of Psychiatry, GSL Medical College, Rajahmundry, Andhra Pradesh, India
3 Registrar, Hunter New England Training in Psychiatry, New South Wales, Australia

Correspondence Address:
Dr. V. V. Jagadeesh Settem
Department of Psychiatry, GSL Medical College, Rajahmundry, Andhra Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/amhs.amhs_267_21

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Background and Aim: With the advent of pharmacological agents, there were many changes in prescription patterns for modified electroconvulsive therapy (MECT) over time across the globe. This study aims to evaluate the main indications and prescription patterns of MECT in a tertiary care center. Materials and Methods: A retrospective medical record review was done in a tertiary care hospital after the institutional ethics committee approval, accessing the MECT records of 310 patients who underwent the procedure during the 5-year study period using a semi-structured pro forma. Results: In our file review, we found that the most common diagnosis, for which MECT was prescribed, was schizophrenia 146 cases (47%), and the common indication was augmentation of therapy/to speed up the rate of improvement. Depressive disorder was the primary diagnosis in 81 (26%) cases followed by mania in 46 (15%) cases. Among the major symptomatology which led to the primary use of MECT, suicidality accounted for 72 (23.2%) cases and catatonia in 34 (11%) cases. The mean number of MECTs during the course was 6.4 (2.5) in bipolar disorder, and in schizophrenia, it was 6.3 (2.3). A response rate of 85% was observed. Patient acceptability of MECT was good as only seven (2.3%) patients withdrew consent after initiation of treatment. Conclusion: Most common diagnosis, for which MECT was prescribed, was schizophrenia followed by depression. MECT was most commonly used as an augmentation strategy; however, in case of depression, it was used as first line of management. Response rate to MECT and acceptability were good in majority.

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