Electroconvulsive therapy for severe depression

Electroconvulsive therapy is more effective than simulated ECT or antidepressant drugs for symptom reduction in severe depression.

A topic in Clinical Evidence summarizes the results of a systematic review on electroconvulsive therapy (ECT) in depression. Compared to simulated ECT (6 RCTs, 256 people), ECT improved symptoms over 1–6 weeks (mean difference, Hamilton Depression Rating Scale score (HAM-D) 9.7, 95% CI 5.7 to 13.5). Compared to antidepressant drugs (18 RCTs, 1144 people) ECT improved symptoms over 3–12 weeks (mean difference, HAM-D 5.2, 95% CI 1.4 to 8.9). Bilateral ECT was more effective than unilateral ECT and high-dose ECT was more effective than low-dose ECT. The studies were underpowered to detect rare adverse events. Short-term cognitive impairment immediately after ECT was observed, but there was no evidence of long-term cognitive impairment at 6 months according to one RCT.

Ədəbiyyat

1. Geddes J, Butler R, Hatcher S, Cipriani A. What are the effects of treatments in mild to moderate or severe depression? Clinical Evidence 2005;13:1244-1263.
2. UK ECT Review Group. Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet 2003 Mar 8;361(9360):799-808.