Seizure Threshold in ECT: II. Dose Titration vs Age and Half Age Methodst
WORRAWAT CHANPATTANA, M.D.*,
PISARN TECHAKASEM, M.D.***,
SOMCHAI CHAKRABHAND, M.D.**,
SUNEE RAKSAKIETISAK, Ph.D.****
Affiliation : *Department of Psychiatry, Srinakharinwirot University,
**Srithunya Hospital, Bangkok 11000,
***Vajira Hospital, Bangkok 10300,
****Department of Mathematics, Srinakharinwirot University, Bangkok 10300, Thailand.
t Supported by The Thailand Research Fund, grant BRG 3980009.
AbstractSeizure threshold determination is of crucial importance in optimizing electrical stimulus
dosage at electroconvulsive therapy (ECT). We measured initial seizure threshold by means of
Srinakharinwirot University titration schedule in 106 patients with s~hizophrenia or schizo:
affective disord~r, receiving bilateral ECT. Seizure threshold was approximately 106 milli-
coulombs on average, and varied 5-fold across patients. Seizure threshold was directly related
to age, but inversely related to motor seizure duration. Comparisons of stimulus charge were
done with the Age and Half age methods. By using the Half age method, 68 per cent of patients
would have seized at the first stimulation and resulted in a closer mean charge to dose-titration
method than the Age method. The results may have important clinical implications for stimulus
dosing strategy in ECT.
Keywords : Electroconvulsive Therapy (ECT), Schizophrenia, Initial Seizure Threshold, Sri-nakharinwirot University Titration Schedule, Pose-Titration vs Age and Half Age Methods
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