Electroconvulsive therapy (ECT) is an effective treatment for many psychiatric disorders. However, many issues regarding its practice have not yet been well understood. This explains, at least in part, the variability of its application in different services and the lack of clear protocols for its practice. The present paper is a systematic review of the literature on ECT (ME-DLINEÒ 1993-2003). It aims to answer the following questions: Is there any difference in efficacy between unilateral or bilateral ECT? What is the real importance of the convulsive threshold? What is an adequate convulsive crisis and how to proceed in its absence?
Electroconvulsive therapy; stimulus intensity; electrode placement; seizure threshold; efficacy
