A 60-year-old normotensive woman, who 3 years previously had had a cerebral haemorrhage, developed a severe depressive illness that failed to respond to tricyclic antidepressants and lithium, alone and combined. Electroconvulsive therapy (ECT) was administered using intravenous beta-blockade with practolol and atenolol prior to induction of anaesthesia to prevent the surge in blood pressure normally seen following the convulsion. The blood pressure did not rise and her depression responded to a series of nine ECT treatments. There were no associated complications.