ECT IN PATIENTS WITH MAJOR DEPRESSIVE DISORDER AND LOW CARDIAC-OUTPUT

Electroconvulsive therapy (ECT) in patients with impaired cardiac outp ut may be associated with significant cardiovascular morbidity and mor tality because of its hemodynamic effects. Many clinicians are relucta nt to treat these patients with ECT because of the high risk associate d with the treatment. In this report, we present a clinically appropri ate protocol for ECT treatment of patients with impaired cardiac outpu t and major depressive disorder. Three patients, ages 59-78, years, wi th resistant major depression and impaired cardiac out8ut (ejection fr action 20-25%), were successfully treated with ECT according to this p rotocol.