Author's reply

I am grateful to Professor Chiesa for his comments on my Highlights' piece in March's BJPsych.¹ It is inevitably a challenge to get as much detail as I would like into a one-page column that endeavours to capture some major points from most of that month's Journal content. The primary intent is to encourage the reader to engage with the primary articles mentioned, although of course accuracy and balance are important. Re-reading my column in light of Professor Chiesa's comments, I do not believe that I wrote or inferred that there is ‘no reliable and convincing evidence with regard to the effectiveness of electroconvulsive therapy (ECT)’, although I noted the challenge of the lack of randomised controlled trials – often considered the best form of evidence – and the reasons why this might be the case. Within the remit of the column, I did not, and do not, feel that I was obligated to ‘explain the basis upon which proponents of ECT continue to practice this intervention on a relatively large scale’, although I recognise that this is a concern of many. I am grateful to Professor Chiesa for his subsequent identification of some specific literature on ECT, some of which I was familiar with, some of which was new to me; the papers reaffirm the ongoing need for more and better research in this field.