1. The seizure must last a minimum of 25 seconds and should not last longer than two minutes. If the seizure lasts less than 25 seconds, wait one minute and then stimulate again. Electrical stimulation should be discontinued after three failed attempts.

2. If seizures exceed two minutes, intravenous diazepam is used to terminate the seizure.

3. Treatments are given two to three times per week. A minimum of six treatments are usually required (common course is 8-12 treatments). The first three are often performed with bilateral electrode placement. Up to twenty treatments may be necessary before maximum response is attained.

III. Contraindications to Electroconvulsive Therapy include intracranial mass, recent stroke, and recent MI. The procedure is very safe, and the complication rate is comparable to that of anesthesia alone.

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