Hi everyone,

I've just written a long update post but it's disappeared!!

Thanks to everyone for your help, and apologies for the delay in getting back to you all. The links provided were incredibly useful. We were able to use the information to discuss options with the doctor for reducing my partner's seizure threshold. In the end we went for:

-250mg caffeine in addition to the anaesthesia
-Ketamine as a supplement to the anaesthesia
-Waiting two minutes longer before beginning the ECT (to weaken the anaesthetic effect)
-Having the anaesthetist hyperventilate my partner during the process

We've now had two sessions with full seizures, so a great result. My partner's also gone onto nortriptyline in line with recent research on its ability to enhance ECT's effects.

Re: starting with bilateral, I think it's because we're in Germany and that's just what they do here. I believe it's the same in the UK, and the Royal College of Psychiatrists is one of the world's leading ECT practice bodies. There's an increased risk of temporary memory loss with bilateral as I understand the situation (and I've already observed this in my partner) - but we're fighting suicidal ideation, so that's not our main concern. We're also working with the first doctor in Germany to be licensed to perform ECT on an outpatient basis, so I guess everything is strictly regulated to what they do in the hospitals. At the end of the day we're happy to try it, and I'm confident that we're being well advised. My partner has an excellent psychiatrist here in Berlin who recommended ECT to us and is monitoring everything; we've tried so much over the past few years with no results. ECT is a relatively safe and proven treatment, so it's our first choice at this stage in the game.

I have one more question for you all, if you don't mind! We have two more weeks before the doctor goes away on holiday for two weeks. If everything goes to plan, my partner will have had eight successful ECT sessions by that point. We're aiming for twelve in total, so does anyone know if a break will harm the results? I guess we won't have to start from the beginning again, but perhaps we'll essentially have to repeat a few of the sessions? Any links/advice would be greatly appreciated. I'll be able to ask the doctor in person when we speak to him on Tuesday, but some advice before then would be brilliant.

Thanks again for all of your support!