Editing Electroconvulsive therapy (section)

====Follow-up====
There is little agreement on the most appropriate follow-up to ECT for people with major depressive disorder.<ref name="Jelovac2013Rev">{{cite journal | vauthors = Jelovac A, Kolshus E, McLoughlin DM | title = Relapse following successful electroconvulsive therapy for major depression: a meta-analysis | journal = Neuropsychopharmacology | volume = 38 | issue = 12 | pages = 2467–2474 | date = November 2013 | pmid = 23774532 | pmc = 3799066 | doi = 10.1038/npp.2013.149 }}</ref> The initial course of ECT is then transitioned to maintenance ECT, pharmacotherapy or both. When ECT is stopped abruptly, without a bridge to maintenance ECT or medications (usually antidepressants and [[Lithium (medication)|Lithium]]), it is associated with a relapse rate of 84%.<ref name="Espinoza 2022" /> There is no defined schedule for maintenance ECT, however it is usually started weekly with intervals extended permissibly with the goal of maintaining remission.<ref name="Espinoza 2022" /> When ECT is followed by treatment with [[antidepressants]], about 50% of people relapsed by 12 months following successful initial treatment with ECT, with about 37% relapsing within the first 6 months. About twice as many relapsed with no antidepressants. Most of the evidence for continuation therapy is with [[tricyclic antidepressants]]; evidence for relapse prevention with newer antidepressants is lacking.<ref name=Jelovac2013Rev/>{{update after|2025|3|26}} Adjunct maintenance ECT paired with [[cognitive behavioral therapy]] has also been shown to reduce relapse rates.<ref name="Espinoza 2022" /> Maintenance ECT may safely continue indefinitely, with no set maximum treatment interval established.<ref name="Espinoza 2022" />

[[Lithium (medication)|Lithium]] has also been found to reduce the risk of relapse, especially in younger patients.<ref name="Lambrichts Detraux Vansteelandt Nordenskjöld 2021 pp. 294–306">{{cite journal | vauthors = Lambrichts S, Detraux J, Vansteelandt K, Nordenskjöld A, Obbels J, Schrijvers D, Sienaert P | title = Does lithium prevent relapse following successful electroconvulsive therapy for major depression? A systematic review and meta-analysis | journal = Acta Psychiatrica Scandinavica | volume = 143 | issue = 4 | pages = 294–306 | date = April 2021 | pmid = 33506961 | doi = 10.1111/acps.13277 | s2cid = 231759831 | hdl = 10067/1751810151162165141 | url = https://lirias.kuleuven.be/handle/123456789/669413 | hdl-access = free }}</ref>