FOR DEBATE: THE EVIDENCE FOR ELECTROCONVULSIVE THERAPY (ECT) IN THE TREATMENT OF SEVERE LATE-LIFE DEPRESSION

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Since the first human application of electroconvulsive therapy (ECT) by Cerletti and Bini in 1938 (Endler, 1988), its history has been replete with examples of both successes and failures. The failures have been related not only to adverse effects but also to the use of ECT at various times without appropriate clinical indications. Acknowledging that ECT has been misused and abused in the past, professional organizations have made strenuous efforts to develop guidelines for its proper use (American Psychiatric Association, 2001). However, persisting stereotypes have fostered fear and distrust in patients and their families, as well as in the general public and popular media (Brewis, 2001), sometimes resulting in reduced access to ECT.