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Once weekly and three times weekly schedules of ECT, each at two stimulus dose levels (high and low), were compared for therapeutic efficacy in melancholia. Three times weekly ECTs were more efficacious than once weekly ECTs. A high stimulus dose did not enhance the efficacy of once weekly ECTs. However, the patients who remitted did so over a comparable time-course regardless of the ECT schedule. Although three times weekly ECTs are superior, 55% of patients responded to once weekly ECTs. There is therefore a need for research to identify the patients for whom once weekly ECT may be sufficient.