THERAPEUTIC ADVANTAGE OF BIFRONTAL ELECTRODE PLACEMENT IN ECT

Fifty-nine patients suffering from a major depressive episode, for who m electroconvulsive therapy (ECT) was clinically indicated, were rando mly assigned to one of three electrode placement groups for treatment with brief pulse, threshold-level ECT: bitemporal (BT), right unilater al (RU) or bifrontal (BF). Comparison of these groups in terms of numb er of treatments, duration of treatment, or incidence of treatment fai lure, showed that the bilateral placements were superior to the unilat eral; comparison of Hamilton, Montgomery-Asberg, and visual analogue s cale scores showed that the bifrontal placement was superior to both b itemporal and unilateral treatment. Bitemporal treatment showed therap eutic results intermediate between BF and RU. Because BF ECT causes fe wer cognitive side effects than either RU or BT, and is independently more effective, it should be considered as the first choice of electro de position in ECT.