https://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2017.pp11a3

This is a landmark study for treatment of depression: They are now moving the benchmark to third line treatment for ECT; that is, after two failed trials of two antidepressants or one antidepressant and one psychotherapy, patient would go on to ECT. This is very aggressive, but the projected models show distinct improvement in Quality of Life.