Should clinicians begin ECT treatment sooner than previously thought or utilize implanted vagus nerve stimulation (VNS)?
In many situations, it is appropriate to consider ECT earlier rather than later. Modern ECT is a benign procedure. Thus, I believe it is a clinical mistake to allow a patient to remain severely ill and subjected to many antidepressant trials before offering ECT. The application of ECT should be determined by the severity of the patient’s illness. For those patients who are most severely symptomatic with typical MDD symptoms, clinicians should consider ECT among the treatment options. Unfortunately, many clinicians are reluctant to consider ECT sooner. This is a prejudice that should be overcome.
