The International Journal of Neuropsychopharmacology

Rapid Communication

A comparison of RUL ultrabrief pulse (0.3 ms) ECT and standard RUL ECT

Colleen K. Looa1a2a3a4 c1, Kirby Sainsburya2, Patrick Sheehana2 and Bill Lyndona2a5

a1 School of Psychiatry, University of New South Wales, Sydney, Australia

a2 The Northside Clinic, Sydney, Australia

a3 St George Hospital, South Eastern Sydney Illawarra Health Service, Australia

a4 Black Dog Institute, Sydney, Australia

a5 Discipline of Psychological Medicine, University of Sydney, Sydney, Australia


An important goal in electroconvulsive therapy (ECT) research is to minimize associated cognitive side-effects while maintaining its high efficacy. This study explored the use of a novel approach, right unilateral (RUL) ECT with an ultrabrief pulsewidth (0.3 ms) (RUL-UB), in comparison with standard RUL ECT. Seventy-four depressed in-patients received RUL-UB ECT at six times seizure threshold, and 22 patients received standard RUL ECT (1.0 ms pulsewidth) at five times seizure threshold. Formal, prospective evaluations of mood and cognitive functioning over the treatment course were done by a rater blinded to treatment condition. Efficacy was maintained using the ultrabrief pulsewidth, with equivalent numbers of responders and remitters to the standard RUL ECT group, although the speed of response was slower. Cognitive outcomes were superior in the RUL-UB ECT group, particularly in the retention of verbal and visual information, as well as in retrograde autobiographical memory.

(Received June 26 2008)

(Reviewed July 06 2008)

(Revised July 14 2008)

(Accepted July 22 2008)

(Online publication August 28 2008)


c1 Address for correspondence: Associate Professor C. K. Loo, Level 2, James Laws House, St George Hospital, Kogarah, NSW 2217, Australia. Tel.: 61-2-9113-2039 Fax: 61-2-9113-3734 E-mail: