title: Safety considerations for outpatient electroconvulsive therapy.
abstract: As electroconvulsive therapy (ECT) requires general anesthesia and is associated with both cognitive and non-cognitive side effects, careful consideration must be given to the safety aspects of providing ECT on an outpatient basis. Drawing upon published literature and their clinical experience administering outpatient ECT, the authors propose best practices for safely providing ECT to outpatients. They review criteria for selecting patients for outpatient ECT as well as treatment and programmatic issues. The authors highlight the importance of educating referring clinicians as well as patients and their families about factors involved in the safe delivery of ECT for outpatients. Fiscal considerations and the drive toward reduced length of stay are prompting insurers and caregivers to choose outpatient over inpatient ECT. For each patient, such a choice merits a careful analysis of the risks of outpatient ECT, as well as the implementation of measures to ensure patient safety.
authors.affiliation: The Johns Hopkins University, and The Johns Hopkins Hospital, Baltimore, MD 21205, USA. imreti@jhmi.edu
authors.forename: Irving M
authors.initials: IM
authors.lastname: Reti
authors.forename: Melinda
authors.initials: M
authors.lastname: Walker
authors.forename: Kathy
authors.initials: K
authors.lastname: Pulia
authors.forename: Jesus
authors.initials: J
authors.lastname: Gallegos
authors.forename: Geetha
authors.initials: G
authors.lastname: Jayaram
authors.forename: Punit
authors.initials: P
authors.lastname: Vaidya
mesh_terms: D000075202:Contraindications; D004565:Electroconvulsive Therapy / Q000009:adverse effects / Q000191:economics / Q000592:standards; D006801:Humans; D010045:Outpatients; D017410:Practice Guidelines as Topic / Q000592:standards*