ECT Seizure Threshold Risk Estimator

Estimates electroconvulsive therapy (ECT) seizure threshold based on patient age, electrode placement, and other clinical factors. Higher thresholds require higher electrical doses for effective seizure induction.

years

Check if patient is taking any threshold-raising medications

sessions

Threshold typically rises with successive treatments

Note: Common dosing strategies: (1) Dose titration method (start low and increase until adequate seizure); (2) Half-age method (age × 0.5 = stimulus dose in charge units for RUL); (3) 5× seizure threshold method for RUL. Bitemporal placement typically requires 1.5-2× the RUL dose.

References

  1. Seizure threshold in electroconvulsive therapy: a clinical guide. Journal of ECT (2000). https://pubmed.ncbi.nlm.nih.gov/10970068/
  2. Clinical Handbook for the Management of Mood Disorders. Cambridge University Press (2013). https://www.cambridge.org/core/books/clinical-handbook-for-the-management-of-mood-disorders/
Medical Disclaimer

This calculator is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.

  • This is an estimator only; actual seizure threshold must be confirmed by stimulus titration or fixed-dose protocols.
  • Individual variation in threshold can be large; always monitor with EEG/EMG during ECT.
  • Propofol and benzodiazepines significantly raise threshold; consider dose reduction or switching agents if seizure quality is poor.