Britain Issues Guidance on Use of Shock Therapy

May 2, 2003

LONDON (Reuters Health) - Electroconvulsive therapy (ECT) should only be used to achieve quick improvement of severe symptoms in people with depression, catatonia or prolonged manic episodes, according to new guidelines issued by British authorities on Thursday.

The National Institute for Clinical Excellence (news - web sites) (NICE) also said the controversial treatment should be limited to patients whose condition is considered to be potentially life-threatening, and used only after other treatment options have failed.

Professor Peter Littlejohns, clinical director and executive lead for this appraisal said NICE was aware of concerns about the use of ECT and the guidance took into account "the full range of views and directly addresses some of the main concerns."

"This guidance is good news for service users and health professionals," he said. "There is now clear national guidance on ECT use and on obtaining consent to the procedure."

The guidelines stress that the decision to use ECT should be made jointly by the individual and doctors responsible for treatment. Consent should be obtained "without pressure or coercion" in all cases where the patient is able to grant or refuse consent, according to the guidelines.

"The individual should be reminded of their right to withdraw consent at any point," NICE said.

The launch of the guidance coincides with the launch of an accreditation program for health professionals who use ECT developed by the Royal College of Psychiatrists Research Unit.

Littlejohns said the accreditation program meant standards (news - web sites) could be raised further "by ensuring that not only are health professionals following NICE guidance, but they are properly trained and their practices have been peer reviewed."

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