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Table 2 Exclusion Criteria

From: The study protocol of the Norwegian randomized controlled trial of electroconvulsive therapy in treatment resistant depression in bipolar disorder

Earlier ECT none response

ECT within the last six months

Rapid cycling BD (e.g.4 or more episodes per year)

Use of medication or substances (such as pethidine, alcohol, drugs) incompatible with treatment (medication or ECT). Such medication must be stopped a least 5 half-lives before start of treatment.

Current use of all other psychotropic medication during the study period with the exception of the following: The use of alimemazine (max dose 30 mg daily), chlorpromazine (max dose 25 mg × 2 daily) and chlorprothixene (max dose 20 mg × 2) is allowed. The use of mianserine (max dose 10 mg daily) is allowed.Medication related to the ECT procedure is allowed.

For Medication in control group refer to Medication in control group - Treatment As Usual

Inability to comply with study protocol

Unstable serious medical conditions, including clinically relevant laboratory abnormalities

Conditions that affect neuropsychological assessment such as Parkinson's Disease, Multiple sclerosis, stroke, alcohol and substance abuse or dependence (according to SCID or DSM-IV-TR)

Fertile women without adequate contraception (Adequate contraception includes: abstinence, oral contraceptives, intrauterine devices, barrier method)

Young Mania Rating Scale (YMRS) [43] of 20 or more

Patient at high suicidal risk according to clinicians' judgement