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Electroconvulsive therapy (ECT) is an effective, if somewhat controversial, treatment for a number of psychiatric disorders, particularly depression. Although use has declined, this is not due to lack of evidence to support the use of ECT, but because other treatments for psychiatric disorders, not always grounded in evidence, are being chosen. GPs are likely to have patients who have received ECT, or for whom ECT may well be considered following a referral to secondary care. This article considers the origins of ECT, the indications for use and side effects.