| Definitely effective |
| Unipolar major depression |
| Refractory or resistant to antidepressant therapy |
| Need exists for rapid treatment response, such as in pregnancy, persistent suicidal intent, or food refusal leading to dehydration or nutritional compromise |
| Medical comorbidities prevent the use of antidepressant medication |
| Previous response to ECT |
| Psychotic features (eg, delusions or hallucinations) |
| Catatonia |
| Persistent suicidal intent |
| Bipolar depression or mania |
