There are no systemic illnesses that preclude the administration of ECT when the treatment is clearly warranted, although some conditions call for special care. Among them are severe hypertension, uncontrolled cardiac arrhythmia, bleeding tendencies, recent myocardial infarction or cerebrovascular lesion, and increased intracranial pressure or brain lesion. The case literature provides ample suggestions for the appropriate treatment with ECT of patients with these conditions. (86 6 and

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