Experts say that when used for the right clinical conditions, ECT can "dramatically" benefit the patient.
Those who support its use say that in nearly three quarters of cases people with depressive illness showed "a definite improvement" after ECT.
Every patient receiving the treatment receives on average about eight sessions.
Dr Avi Dhariwal, Birmingham and Solihull's lead psychiatrist on ECT, claimed the actual number of patients given the treatment was low compared with the rest of the country.
Part of the reason, he said, was due to the city's relatively young population who had a greater prejudice towards the treatment. Despite this, he believes there are cases where it is the only option.
"If someone is profoundly depressed and at death's door, then they may need it. We don't use it for moderate cases of depression any more because the National Institute for Clinical Excellence make it clear about the patients who can use it. If someone under-stands the treatment and they don't want it we won't give it to them. Ten years ago that used to happen using the Mental Health Act. Now it is only if the patient consents."
Dr Dhariwal accepted there could be permanent side effects, such as memory loss, which people had to be made aware of before treatment.
In addition there are also the minor risks associated with administering a general anaesthetic under which ECT is carried out.
But he added: "In countries in Europe where they don't use it, such as France and Germany, there is a concern about people developing general depression and having no way of treating it.
"They are desperate for alternatives, such as transcranial magnetic stimulation which involves inducing a current in the brain using a magnetic field."
Dr Dhariwal insisted: "There is a core group for whom ECT benefits. Twenty years ago we were using it too widely. Now we are quite selective. I have treated patients who have stopped eating, who won't take tablets.
"If you give them a drip they pull out the tube. They are going to die. The only treatment to get them functioning is ECT."