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  • Question on Consultation

    Do you agree on the proposal for withdrawing this technology appraisal? If not, please can you state why you disagree.

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    Are you aware of any implications for UK clinical practice on withdrawing this technology appraisal? If so, please describe.

2025 surveillance of electroconvulsive therapy (technology appraisal guidanceTA59, NICE guideline NG222, NICE guideline CG178, NICE guideline CG185, NICE guideline CG192)

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Overall impact of new evidence and intelligence

The new evidence identified supports and aligns with current recommendations on the use of ECT in people with depression and prolonged mania. The evidence confirms ECT's effectiveness especially in treatment-resistant populations. However, concerns about cognitive side effects, such as memory impairment, highlight the importance of careful patient information and risk-benefit assessment before proceeding with treatment, especially for repeat ECT. Overall, new evidence identified support the use of ECT in people with treatment resistant depression and people with prolonged mania as the last treatment option where other treatments have failed.

For schizophrenia, more new evidence have been identified to allow more specific positive or negative recommendations to be made for specific subgroups, for example, for severe treatment-resistant cases.

For catatonia, studies confirm ECT's effectiveness for rapid symptom relief in treatment-resistant cases, aligning with TA59 recommendations. Maintenance ECT remains uncertain in terms of long-term benefits, supporting the guideline's cautious approach.

Systemic challenges, including workforce shortages and funding limitations, could impact the delivery and equitable access to ECT. Public Health Scotland's audit (2023) shows that while ECT is effective for many, access remains limited.