Use of electroconvulsive therapy at a university hospital in Karachi, Pakistan: a 13-year naturalistic review

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There are very few reports of electroconvulsive therapy (ECT) from developing countries, where lack of regulation and misuse has lead to negative publicity. We present our experience of ECT use at a university hospital in Karachi, Pakistan, over the course of 13 years. During the study period, 4013 patients were admitted to our inpatient unit, of which 136 (3.38%) received ECT. ECT was conducted under the supervision of consultant psychiatrist and anesthetist with continuous monitoring during and after the procedure. The most common indications were mood disorders. The average number of ECTs administered per patient was 6 (range, 1-20). A total of 35% of patients had medical comorbidities but did not suffer any deleterious effect from the procedure. A total of 75% patients showed improvement in their clinical condition. No major complication was observed in any of the patients. Our study demonstrates the effectiveness if ECT in a low-income, developing country. We strongly recommend following guidelines to ensure patient safety and minimizing side effects. This will ensure better patient acceptability and compliance.


The Journal of ECT