In Reply: Dr Abrams contends that in our continuation pharmacotherapy study the remission rate of 55% for open-phase treatment with ECT was low and this was due to 90% of patients receiving right unilateral ECT with an inadequate electrical dose.1 Abrams incorrectly describes our treatment methods. While the minimal dose was 150% above seizure threshold, a higher dose often was used. In addition, of the 262 patients who started with right unilateral ECT, 50.3% were switched to bilateral ECT and received a mean (SD) of 7.1 (4.3) bilateral ECT treatments. Overall, the remission rate for patients treated only with right unilateral ECT was 68.5% compared with 43.8% for patients who were switched to bilateral ECT or who were treated with only bilateral ECT (χ21
= 17.68, P<.001).
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