title: Switching From Age-Based Stimulus Dosing to Dose Titration Protocols in Electroconvulsive Therapy: Empirical Evidence for Better Patient Outcomes With Lower Peak and Cumulative Energy Doses.
abstract: OBJECTIVE
  The aim of this study was to test the proposition that adoption of a dose titration protocol may be associated with better patient outcomes, at lower treatment dose, and with comparable cumulative dose to that in patients treated using an age-based stimulus dosing protocol.
  
  
  METHODS
  This was an analysis of data assembled from archived records and based on cohorts of patients treated respectively on an age-based stimulus dosing protocol and on a dose titration protocol in the National Health Service in England.
  
  
  RESULTS
  We demonstrated a significantly better response in the patient cohort treated with dose titration than with age-based stimulus dosing. Peak doses were less and the total cumulative dose was less in the dose titration group than in the age-based stimulus dosing group.
  
  
  CONCLUSIONS
  Our findings are consistent with superior outcomes in patients treated using a dose titration protocol when compared with age-based stimulus dosing in a similar cohort of patients.
authors.affiliation: From the Northamptonshire Healthcare Foundation Trust, Northampton, United Kingdom.
authors.forename: Alex
authors.initials: A
authors.lastname: O'Neill-Kerr
authors.forename: Anhar
authors.initials: A
authors.lastname: Yassin
authors.forename: Stephen
authors.initials: S
authors.lastname: Rogers
authors.forename: Janie
authors.initials: J
authors.lastname: Cornish
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging; D015331:Cohort Studies; D016208:Databases, Factual; D061218:Depressive Disorder, Treatment-Resistant / Q000523:psychology / Q000628:therapy; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012640:Seizures; D016896:Treatment Outcome