In the recent past, we have published a retrospective study primarily aimed at investigating inpatient treatment practices for mania.5 ECT was used in one-third of 425 admissions for mania (bilateral electrodes, sinusoidal device, anesthesia with succinylcholine and thiopental). Lithium was frequently used concurrently with ECT (in 63% of the cases; N=90), as well as antipsychotics (in 82%), anticonvulsants (31%), antidepressants (4%), and benzodiazepines (47%). Deaths were neither reported with the lithium/ECT association, nor in a non-lithium ECT subgroup (N=51). Length of stay was not significantly altered because of lithium (20.3 [12.9] versus 21.1 [9.12] days) or of other concomitant medication. The average number of ECT sessions was similar in patients with lithium (5.6 [2.5]) and without lithium (6.2 [2.4]). The average number of internal-medicine referrals during admissions was lower in the ECT+lithium subgroup (1.9 [1.9]) than in the non-lithium ECT subgroup (2.8 [2.8]; p=0.02), and the number of psychiatric calls was statistically similar in patients receiving concomitant lithium (5.3 [6.6]) and not receiving it (6.7 [7.5]). Post-ECT length of stay was not influenced by the concomitant use of lithium (3.5 [6.4] versus 2.9 [5.2]). However, cognitive side effects were not directly assessed in that study.