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                  <text>October 3,

19 83

Dorson Liss, M.D.
Chairman, Special Procedures Committee
Good Samaritan Hospital
2425 Samaritan Drive
San Jose, California 9512!;
Dear Dr. Liss,
The literature on maintenance ECT is not reassuring. The principal studies
in my book on ECT (Pg 207). The APA Task Force was unable to find
detailed
are
satisfactory data to allow a recommendation, so reference to such studies was
included among the research needs in the Task Force Report.
This question has been asked by a number of other respondents. The best
suggestion that I was able to make reﬂected the present practice on my service at
University Hospital. About half our effectively ill patients who respond to a course
of ECT are discharged on maintenance drug therapy, usually imipramine, less often
lithium or phenelzine. When such patients relapse, and recover in a second course
of ECT, we then consider discharge on maintenance ECT, initially recommending
weekly treatments for 2 to 4 weeks, then bi-weekly for a month. We have not
treated a patient beyond 6 treatments as an out-patient, always trying a second
course of a maintenance drug trial. I am not satisfied with this experience, and did
propose a study which was not approved by granting agencies.
would be grateful for a copy of your recommendations when these are
adopted at your hospital.
I

Thank you for your inquiry.

Sincerely yours,

Professor of Psychiatry

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