In the long term, after adequate treatment, of medical conditions enhancing somatic risks, no absolute contraindications are acknowledged (conditions including higher somatic risks are

described in Table II). In addition, every other untreated severe medical and life-threatening anesthesiological risk has to be taken into account. If treated insufficiently, these conditions become relative contraindications, Inhibitors,research,lifescience,medical and an individual and interdisciplinary benefit/risk analysis has to be performed for each learn more patient. In general, each factor enhancing the risk for ECT or anesthesia should be taken into consideration. In case of the described specific risks interdisciplinary counseling may be necessary. Afterwards the higher somatic risk has to be compared with the

risk of an insufficiently treated or prolonged psychiatric illness. Patients and relatives or responsible legal guardians have to be informed about rislcbcnefit ratios Inhibitors,research,lifescience,medical to contribute to a shared decision. Conclusion ECT is a nonpharmacologic biological treatment which has been proven to be a. highly effective treatment option predominantly for depression, but also for schizophrenia in a variety of controlled investigations. This is not. onlytrue in acute treatments; ECT can also be used for relapse prevention during maintenance therapies. In addition, the safety and tolerability Inhibitors,research,lifescience,medical of electroconvulsive treatment have been enhanced by using modified stimulation

techniques and by progress in modern anesthesia. During recent Inhibitors,research,lifescience,medical years, clinical conditions considered as absolute contraindications for EXT in former times became relative contraindications. Thus, today a. safe treatment can also be offered to patients with higher somatic risks. Recent research has contributed to an enhancement of the knowledge of possible mechanisms of action of ECT and to a. safe and well tolerated treatment, Inhibitors,research,lifescience,medical but unfortunately the final clarification of the underlying crucial mechanisms still remains unresolved. Nevertheless, this highly effective therapeutic option should L-NAME HCl not. kept, back, especially from patients suffering from psychiatric illnesses which arc unresponsive to other treatments. ECT still represents an important option in the therapy of treatment-resistant depression. Thorough information provision in hospitals, and also the growing objective and unbiased information in the press and other media, could contribute to fighting the prejudice and stigma of psychiatric disorders and specific therapies such as ECT. Select abbreviations and acronyms C-ECT continuation ECS electroconvulsive shocks ECT electroconvulsive therapy GABA γ-aminobutyric acid Contributor Information Thomas C. Baghai, Dept of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Germany. Hans-Jürgen Möller, Dept of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Germany.