In the 1940s and 1950s, ECT became the mainstay of biological treatment in psychiatry. With the introduction of psychotropic medications in the late 1950s, and the fact that ECT was perceived as the most invasive of the commonly used psychiatric treatments at the time, the clinical use of ECT greatly diminished. The 1970s saw the beginning of a new era in ECT research as a growing awareness of the limitations, safety issues, and side effects of psychotropic medications became apparent. The rates of utilization of ECT stabilized in the United States after a 20-year decline and, in fact, its use has increased in recent years.