When a combination of antidepressants and psychotherapy fails to control severe mental illness, there's hope on the horizon. ECT can be a reliably safe and effective option. For some patients, using it as maintenance therapy makes sense, said Vaughn McCall, MD, editor-in-chief of The Journal of ECT and professor and chairman of psychiatry at the Medical College of Georgia in Augusta. "I would think of it the same way as you have to treat any chronic illness," such as blood pressure medicine to keep hypertension in check and dialysis to prevent kidney failure. Despite a cacophony of contrarian voices — mainly from the Church of Scientology — "the number of psychiatrists who see controversy in ECT is vanishingly small," McCall said. "Within the discipline of psychiatry itself, there really is no controversy." In weighing the pros and cons of ECT, he noted that "when you're trying to decide if it's worth doing a treatment, you're looking at the effectiveness on one hand and the side effects on the other hand."