Safety of electroconvulsive therapy in the context of physiological and medical complexity: A state‐of‐the art review
2025

Safety of Electroconvulsive Therapy in Complex Medical Conditions

Sample size: 124 publication Evidence: moderate

Author Information

Author(s): Elias Alby MD, FRANZCP, PhD, Soumitra Das MD, FRANZCP, MPH, James Kirkland MBBS, Sarabjit Loyal M (MED), FRANZCP, Naveen Thomas DPM, MD, DNB, FRANZCP

Primary Institution: The University of Melbourne

Hypothesis

Can electroconvulsive therapy (ECT) be safely administered to patients with various medical conditions and physiological complexities?

Conclusion

ECT is generally safe even in patients with medical and physiological complexities, although certain conditions may require caution.

Supporting Evidence

  • Mortality directly attributed to ECT is extremely rare.
  • Certain medical conditions may indicate a high risk for ECT.
  • Risks can be mitigated with safety protocols and collaboration with specialists.
  • ECT remains a relatively safe treatment even in the presence of medical complexities.

Takeaway

This study looks at how safe electroconvulsive therapy is for people who have other health problems. It finds that ECT is usually safe, but doctors need to be careful in some cases.

Methodology

The authors conducted a literature review using PubMed and Embase to evaluate contraindications and precautions during ECT.

Potential Biases

The review may be biased due to a nonsystematic selection of literature.

Limitations

The findings are based on limited evidence from case reports and retrospective reviews, which may not capture all serious outcomes.

Digital Object Identifier (DOI)

10.1002/pcn5.70051

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