title: Continuation and maintenance electroconvulsive therapy for mood disorders: review of the literature.
abstract: BACKGROUND
  Electroconvulsive therapy (ECT) is a highly effective treatment for mood disorders. Continuation ECT (C-ECT) and maintenance ECT (M-ECT) are required for many patients suffering from severe and recurrent forms of mood disorders. This is a review of the literature regarding C- and M-ECT.
  
  
  METHODS
  We conducted a computerized search using the words continuation ECT, maintenance ECT, depression, mania, bipolar disorder and mood disorders. We report on all articles published in the English language from 1998 to 2009.
  
  
  RESULTS
  We identified 32 reports. There were 24 case reports and retrospective reviews on 284 patients. Two of these reports included comparison groups, and 1 had a prospective follow-up in a subset of subjects. There were 6 prospective naturalistic studies and 2 randomized controlled trials.
  
  
  CONCLUSIONS
  C-ECT and M-ECT are valuable treatment modalities to prevent relapse and recurrence of mood disorders in patients who have responded to an index course of ECT. C-ECT and M-ECT are underused and insufficiently studied despite positive clinical experience of more than 70 years. Studies which are currently under way should allow more definitive recommendations regarding the choice, frequency and duration of C-ECT and M-ECT following acute ECT.
authors.affiliation: The Zucker Hillside Hospital, North Shore-LIJ Health System, Glen Oaks, NY, USA. petrides@lij.edu
authors.forename: Georgios
authors.initials: G
authors.lastname: Petrides
authors.forename: Kristen G
authors.initials: KG
authors.lastname: Tobias
authors.forename: Charles H
authors.initials: CH
authors.lastname: Kellner
authors.forename: Matthew V
authors.initials: MV
authors.lastname: Rudorfer
mesh_terms: D004565:Electroconvulsive Therapy / Q000009:adverse effects / Q000191:economics / Q000379:methods* / Q000523:psychology*; D006801:Humans; D019964:Mood Disorders / Q000628:therapy*; D055502:Secondary Prevention