Continuation Electroconvulsive Therapy With Pharmacotherapy Versus Pharmacotherapy Alone for Prevention of Relapse of Depression

Nordenskjöld, Axel; Knorring, Lars von; Ljung, Tomas; Carlborg, Andreas; Brus, Ole; Engström, Ingemar

doi:10.1097/yct.0b013e318276591f

Cited by 63 publications

(76 citation statements)

References 17 publications

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“…At least one smaller study has reported favorable relapse rates (32% at 1 year) among both remitters and responders utilizing continuation ECT as a maintenance strategy. 33 Hence, it is possible that the CCBT intervention utilized in this study did not have a direct effect on the low rate of relapse among remitters. On the other hand, a prior randomized trial utilizing group CBT as a maintenance strategy was superior to both continuation pharmacotherapy and continuation ECT; 23 hence, it is also possible CCBT could be an effective strategy or adjunctive treatment to maintain remission or response in ECT patients.…”

Section: Discussionmentioning

confidence: 93%

“…The MADRS was administered on a monthly basis. Similar to other research, 33 relapse was defined as having a MADRS score ≥ 20 at final visit, hospitalization for depression or suicidality, or needing another index course of ECT treatments (3 times weekly). As this was a pilot, feasibility study, the principal question we aimed to answer was whether subjects would actually complete the CBT lessons online in their own homes on their own time.…”

Section: Methodsmentioning

confidence: 99%

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Computer-Assisted Cognitive Behavior Therapy to Prevent Relapse Following Electroconvulsive Therapy

Ostroff

Sanacora

2017

J ECT

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Objective The goal of this study was to explore the feasibility and potential efficacy of providing computer-assisted cognitive behavior therapy (CCBT) following an index course of electroconvulsive therapy (ECT) to prevent relapse. Method In an open-label trial, subjects with major depressive episode who achieved response or remission following an acute treatment with ECT were recruited to enroll in a 9-module CCBT course. Subjects completed the CCBT modules in their own home at their own pace, but were asked to do at least one lesson per week, such that all 9 lessons would be completed in the first two months. Depression severity and relapse were monitored during the 6 months following ECT. Results Fifteen subjects (10 responders and 5 remitters) enrolled in the study and logged onto the CCBT course. The mean number of online lessons completed was 7.6 (SD 1.7) or 84% of the total lessons and the mean time spent working online was 8.4 hrs (SD 3.9 hrs). During the first two months (the prescribed time period), the mean number of lessons completed was 6.5 (SD 1.8) or 72% and the mean time spent working online was 6.8 hrs (SD 3.2 hrs). Of the entire sample of responders and remitters (n=15), 5 (33%) relapsed at 6 months. Of the 5 remitters, none relapsed during this time period. Conclusion Our results provide preliminary evidence that CCBT after ECT is feasible following ECT. Large, controlled trials are needed to definitively assess whether this strategy is efficacious in preventing relapse.

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Section: Discussionmentioning

confidence: 93%

Section: Methodsmentioning

confidence: 99%

Computer-Assisted Cognitive Behavior Therapy to Prevent Relapse Following Electroconvulsive Therapy

Ostroff

Sanacora

2017

J ECT

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“…Among them, there are several controlled and randomised trials in which ECT-c/m has demonstrated to be effective in the prevention of relapses in patients with affective and psychotic disorders. 5,6,8,9 In fact, it has been pointed out that ECT would be the only somatic treatment in Psychiatry that is usually interrupted when it has demonstrated effectiveness, 23 instead of assessing its continuation.…”

Section: Discussionmentioning

confidence: 98%

Clinical usefulness and economic implications of continuation/maintenance electroconvulsive therapy in a Spanish National Health System public hospital: A case series

Rodríguez‐Jiménez

Bagney

Torío

et al. 2015

Revista de Psiquiatría y Salud Mental (English Edition)

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“…Tal como no caso apresentado, a sua utilização fica reservada para doentes que responderam com sucesso a um curso de tratamento agudo e cuja farmacoterapia de continuação e manutenção apenas falhou na prevenção da recidiva e/ou recorrência. 11 A escolha da venlafaxina prende-se com o facto de ser antidepressivo com dupla ação noradrenérgica e serotoninérgica, com indicação e comprovada eficácia na depressão major. 12 Procurou-se evitar o uso de antidepressivos tricíclicos, pelo efeito adverso comum anticolinérgico, com consequente agravamento da obstipação, queixa física significativa no doente em questão.…”

Section: Discussionunclassified

Depressão Psicótica no Idoso: Desafio Diagnóstico e Papel da Eletroconvulsivoterapia

Coentre¹,

Santos²,

Lopes³

et al. 2016

Gaz Med

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RESUMOOs autores descrevem o caso clínico de um doente com 69 anos com depressão psicótica e sintomas físicos exuberantes. Dados os sintomas físicos significativos e o escalão etário foi efetuada avaliação médica que permitiu excluir doença orgânica. Apesar da terapêutica psicofarmacológica realizada, o doente não apresentou melhoria clínica significativa. Foi efetuada terapêutica eletroconvulsiva ainda na fase aguda, e por recidiva sob terapêutica antidepressiva, também de continuação e de manutenção. Atingiu-se assim uma remissão total do quadro clínico e de funcionamento, tendo o doente retomado a sua atividade profissional. O relato deste caso justifica-se pela sua apresentação peculiar e pelo benefício alcançado com a realização da eletroconvulsivoterapia (aguda e de continuação/manutenção), associado a terapêutica psicofarmacológica que garantiu uma remissão clínica significativa. ABSTRACTThe authors describe the clinical case of a 69-year-old patient with psychotic depression and exuberant physical symptoms. Because of the significant physical symptoms and the age group, a medical assessment was made that allowed organic disease to be excluded. Despite the psychopharmacological therapy, the patient did not present any significant clinical improvement. Electroconvulsive therapy was conducted in the acute phase, and by relapse under anti-depressive therapy, also on-going and for maintenance. A total remission of the clinical and functional situation was achieved and the patient restarted professional activity. The report of this case is justified by its peculiar presentation and the benefit that was achieved with electroconvulsive therapy (acute and continuation/maintenance), associated with the psychopharmacological therapy that ensured a significant clinical remission.

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Continuation Electroconvulsive Therapy With Pharmacotherapy Versus Pharmacotherapy Alone for Prevention of Relapse of Depression

Abstract: The post-ECT relapse rates were substantial in both treatment groups with a statistically significant advantage for combined treatment with pharmacotherapy and continuation ECT. Further studies are needed to define indications for continuation ECT, pharmacotherapy, and their combination.

Cited by 63 publications

References 17 publications

Computer-Assisted Cognitive Behavior Therapy to Prevent Relapse Following Electroconvulsive Therapy

Computer-Assisted Cognitive Behavior Therapy to Prevent Relapse Following Electroconvulsive Therapy

Clinical usefulness and economic implications of continuation/maintenance electroconvulsive therapy in a Spanish National Health System public hospital: A case series

Depressão Psicótica no Idoso: Desafio Diagnóstico e Papel da Eletroconvulsivoterapia

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