A recent article (Effectiveness of left anterior right temporal electrode placement in electroconvulsive therapy: 3 case reports) in the Journal of ECT by psychiatrist Alan Michael Weiss and colleagues at Hunter New England Mental Health and Calvary Mater Hospital, Newcastle, New South Wales, Australia, described the use of maintenance electroconvulsive therapy (ECT) on three women over the age of 65.
The first woman was aged 73, living in a care home and having ECT every two weeks. She had had 196 treatments.
The second woman was aged 77, lived with her son and was having ECT every two weeks. She had had 164 treatments since 2008.
The third woman was aged 84, living in a care home and was having ECT every week. She had had a total of 132 treatments.
The first and third women were receiving ECT with the machine on a very high setting – 706mC.
In spite of trying unilateral and bilateral ECT and a less commonly used form, bifrontal, the authors found that the treatments “were complicated by an inability to generate a seizure, poor quality seizures, and inadequate response”. So they tried an even less commonly used form, left anterior right temporal electrode placement, which they found to be more successful.
The authors said that the three women “lacked insight into their illness” and had been maintained on an involuntary basis under the Mental Health Act (NSW 2007), with a mental health tribunal approving the treatment every 6 months.