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Elongation of pulse width as an augmentation strategy in electroconvulsive therapy

Authors Kawashima H, Suwa T, Murai T, Yoshioka R

Received 2 May 2014

Accepted for publication 26 August 2014

Published 23 October 2014 Volume 2014:10 Pages 2009—2014

DOI https://doi.org/10.2147/NDT.S67121

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Wai Kwong Tang

Hirotsugu Kawashima,1 Taro Suwa,2 Toshiya Murai,2 Ryuichi Yoshioka1

1Department of Psychiatry, Toyooka Hospital, Hyogo, Japan; 2Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan

Abstract: Inducing adequate therapeutic seizures during electroconvulsive therapy is sometimes difficult, even at the maximum stimulus charge, due to a high seizure threshold. Here, we describe two patients with very poor seizure responses at the maximum charge using conventional stimulus parameters in whom responses were successfully augmented by widening the pulse width at the same or even lower stimulus charge. This strategy could be an additional option for seizure augmentation in clinical practice. The potential clinical utility of stimulus parameter modifications should be further investigated.

Keywords: electroconvulsive therapy, pulse frequency, pulse width, stimulus parameter, seizure threshold

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