SUBSTANTIAL research funds and energy have been expended over several decades in attempts to determine the benefits and risks of bilateral and right unilateral electroconvulsive therapy (ECT). Proponents of each method are divided into opposing camps; having been on both sides of the issue, I believe I can fairly state the arguments for each side as follows.
Those favoring bilateral ECT point to the controlled trials demonstrating its greater efficacy and discount its more pronounced adverse cognitive effects as being transient and not different from those of right unilateral ECT weeks or months after a course of treatment. The very infrequent occurrence of prolonged memory impairment after bilateral ECT is acknowledged, but it is held to be a small price to pay for the reduced patient morbidity and mortality thought to result from the use of bilateral ECT.
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