It wouldn't surprise me at all if ECT is now considered a more standard treatment, rather than last-ditch. There are so many meds and endless combinations...it would be absurd to require that first.
There is a man on PC; I think he's a mod- he's not here too much anymore, but it might be really helpful for you to connect with him. He's kind of an old pro at ECT and is very open to discussing it. His name is Guinness.