Treatment-resistant depression (TRD) and schizophrenia (TRS) do not respond to standard therapies and require specialised treatment strategies. Electroconvulsive therapy (ECT) is one such treatment strategy, intended for use in treatment-resistant cases or when a rapid intervention is necessary, such as in suicidality.

We investigated the safety and effectiveness of ECT in terms of suicide-related events, therapy response, remission rates, and side effects in TRD and TRS patients. Results indicate that adding ECT to antidepressants for TRD patients and adding ECT to standard therapies for TRS patients, improves response rates more than monotherapy with antidepressants or standard therapies alone, without significantly increasing the risks for serious adverse events such as somatisation and memory disorders. However, the evidence points to the need for further research, particularly regarding long-term effects, safety and effects compared to other standard treatment options.