Similar clinical improvement of depression using 0.5-ms and 1-ms pulse widths in bilateral electroconvulsive therapy

Is increasing the pulse width from 0.5 to 1 ms an effective strategy to optimize clinical and electrical outcomes in bilateral ECT treatment?

“…In BL ECT, a study that found relatively lower efficacy of UBP raised controversy, 9 but this finding was not replicated in subsequent studies. 1,3,4,10 The present study findings are in concordance with some case reports that have suggested that lengthening the PW might result in improvement in some patients who have an inappropriate seizure or insufficient response with shorter PW (UBP). 5,6 A prolonged chronaxie and the effect of wider PW to activate broader regions of brain tissue 6 have been proposed as explanatory hypotheses for these findings.…”

The likeliness of 0.5 and 1.0 ms stimuli in BL ECT

“…To the editor, I much appreciated the study of de Arriba-Arnau and colleagues [1] comparing the efficacy and global cognitive effects of bilateral ECT induced by brief pulse 0.5 ms and 1.0 ms stimuli. Although retrospective, this study and the outcome add to the insight that the differences, if there are any, must be small.…”