Electroconvulsive therapy effective for major depressive disorder

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Electroconvulsive therapy is effective for depression in patients with suicidal ideation and resistance to other treatments.
Electroconvulsive therapy is effective for depression in patients with suicidal ideation and resistance to other treatments.

Electroconvulsive therapy (ECT) is an effective treatment in patients with depressive disorder with resistance to other treatments, refusal to eat and drink, and suicidal ideation, according to a study published in the Journal of Mood Disorders.

The study included 50 patients aged 25 to 50 years who were diagnosed with major depressive disorder and displayed an ECT indication, including high suicide risk, refusal to accept food or drink,  or deterioration of physical condition, or treatment-resistant depression, among others.

Patients undergoing ECT in which no remission was ensured after use of 2 different groups of antidepressants at sufficient doses and for sufficient durations were described as treatment-resistant, or Group 1. Patients who had current suicidal ideation or suicide attempt with ongoing suicidal ideation were described as the suicidal ideation group, or Group 2. The patients were treated and followed up at inpatient clinics between January and June 2015.

Frequency of ECT sessions was approximately 2-3 times per week. The preferred rate per patient was 7-10 ECT sessions on average; however, the number may have been increased or decreased depending on the clinical response of each patient. The scores of depression both pre- and post-ECT were rated with use of the Hamilton Rating Scale for Depression (HRSD), with normal (ie, non-depressive) scores between 0 and 7, and Clinical Global Impression Scale (CGIS) for the period after application of ECT.

Group 1 had 24 patients and Group 2 had 22 patients. No statistically significant difference was observed between groups in terms of sociodemographic features, total number of ECT sessions, duration of ECT, and HRSD score for pre-ECT period and of 1st and 2nd weeks of ECT.

“CGIS scores checked after each ECT statistically significantly decreased, while the number of patients with decreased CGIS scores obtained after application of ECT increased,” stated Filiz sed, wMD, from Istanbul Bilim University, and colleagues. In addition, 45.5% of the patients with ECT history and 82.9% of the patients without any ECT history went into remission.

According to the authors, “Our study suggested that within the patient groups consisting of those diagnosed with treatment-resistant depressive disorder, the percentage of patients whose HRSD scores decreased by 50% by the end of the 2nd week was 100%.... Suicide ideation decreased by 38.2%, 61.1%, and 80.9% at 1st week of ECT, 2nd week of ECT, and end of ECT, respectively.”

Reference

  1. İzci F, Yilmaz Y, Camkurt MA, et al. Impacts of the duration and number of electroconvulsive therapy (ECT) sessions on clinical course and treatment of the patients with major depressive disorder. J Mood Disord. 2016; 6(3): 99-106 doi: 10.5455/jmood.20160824073455
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