Changes in salt and water balance in patients given ECT are mediated by various mechanisms. Apparently increased secretion of 3-ketosteroids occurs in patients who show clinical benefit after shock; however, this is only a side reaction and is important only in pointing to the increased production of steroid hormones. That other effects of steroid hormones may be responsible for clinical improvement after shock therapy is suggested by available data. It is probable that the therapeutic effect of shock is reparative rather than destructive.Abstract Teaser