The most common diagnostic indication for ECT is major depression (American Psychiatric Association 2001; Thompson et al. 1994). A significant body of literature not only supports the efficacy of ECT for major depression but suggests that it is the most rapid and effective treatment for this condition (Husain et al. 2004; Weiner and Krystal 2001). This literature includes a series of randomized, double-blind, placebo-controlled studies in which the placebo control was "sham ECT," whereby subjects received all aspects of a usual clinical ECT treatment except the electrical stimulus (Brandon 1986). Evidence from meta-analytical studies also suggests greater efficacy with ECT than with antidepressant medication (Janicak et al. 1985; UK ECT Review Group 2003); however, it should be noted that this type of analysis has not been carried out comparing ECT with newer antidepressant medications.