Efficacy, safety and tolerability of formula-based unilateral vs bilateral electroconvulsive therapy in the treatment of major depression: A randomized open label controlled trial

Dominiak, Monika; Antosik-Wójcińska, Anna; Goetz, Zuzanna; Sikorska, Olga; Stefanowski, Bogdan; Gorostiza, Dagny; Święcicki, Łukasz

doi:10.1016/j.jpsychires.2020.12.002

Cited by 17 publications

(16 citation statements)

References 51 publications

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“…In our study, patients over 65 years of age showed also significantly less decline in the retrieval consistency of autobiographical memory (concerning specific events in the past year) than younger patients, although it was noted in both groups. The problem with the decline in this particular memory and its assessment is being widely discussed in the literature [ 48 , 49 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

“…An entirely different matter is also the fact that unilateral ECT is suggested to have better cognitive outcomes [ 20 , 50 ] and was shown to be associated with greater improvement in some cognitive functions [ 48 ]. In our study, the compared age groups did not differ in terms of the proportion of patients receiving a given type of ECT; thus, this variable did not affect the results.…”

Section: Discussionmentioning

confidence: 99%

“…The methodology of clinical assessment was as previously described in the work of Dominiak et al [ 30 , 48 ]. To assess the efficacy of ECT and compare it between groups, we used the Hamilton Depression Rating Scale (HDRS-21) as the primary measure.…”

Section: Methodsmentioning

confidence: 99%

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Electroconvulsive Therapy and Age: Effectiveness, Safety and Tolerability in the Treatment of Major Depression among Patients under and over 65 Years of Age

et al. 2021

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Electroconvulsive therapy (ECT) remains the most effective therapy in treatment-resistant depression. However, the safety of ECT has been consistently questioned, particularly among elderly patients. We assessed the efficacy and safety of ECT in patients before and after 65 years old. The study was conducted between 2015 and 2018 and included 91 patients (61 under and 29 over 65 years old) with major depression undergoing ECT. The Hamilton Depression Rating Scale was used to evaluate efficacy. Cognitive functions were assessed using: MMSE, RAVLT, Trail Making Test, Stroop Test and Autobiographical Memory Interview-Short Form. ECT was more effective in older patients as compared to younger (p < 0.001). No serious adverse events were observed in either group. Increased blood pressure and arrhythmias were more common in the older compared to the younger group (p = 0.044 and p = 0.047, respectively), while disturbances of consciousness did not differ between groups (p = 0.820). Most of the cognitive functions remained unchanged compared to baseline, whereas the outcomes of MMSE, RAVLT and Stroop tests showed greater improvements in the older compared to the younger group (all p < 0.05). The decline in the retrieval consistency of autobiographical memory was more pronounced in the younger group (p = 0.024). ECT is a highly effective, safe and well-tolerated method of treating depression regardless of age.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Electroconvulsive Therapy and Age: Effectiveness, Safety and Tolerability in the Treatment of Major Depression among Patients under and over 65 Years of Age

et al. 2021

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“…Dominiak et al ( 10 ) conducted an open label study in which patients (n=91 intention to treat sample) were randomly allocated into RUL and front-BT ECT groups and the formula-based method was used to set the stimulus dose. Those authors concluded that RUL is a safer procedure because it is associated with a lower incidence of high blood pressure and fewer consciousness difficulties.…”

Section: Ect Techniquesmentioning

confidence: 99%

“…On the other hand, cognitive impairments have been reported, especially regarding memory functions. Autobiographical memory is found to be mostly impaired with effects lasting up to three weeks post-procedure ( 10 ).…”

Section: Ect Effects Safety and Tolerabilitymentioning

confidence: 99%

Efficacy of electroconvulsive therapy as a potential first‑choice treatment in treatment‑resistant depression (Review)

et al. 2021

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Electroconvulsive therapy (ECT) is a technique that has been used since 1938 to treat several psychiatric disorders as a replacement for chemically induced seizures. Despite its history of stigma, controversy and low accessibility, ECT is found to be beneficial and efficient in severe cases of depression where medication fails to bring results. Titration tables developed over time, based on evidenced-based medicine, have made this treatment technique safe and, in some cases, the first choice of treatment. The aim of the review was to summarize the research conducted on the efficacy of ECT on major depressive disorder and variables studied such as technique, comorbidities and medication as well as the effects and outcomes of this procedure. At the same time, the application and correlations with other psychiatric and neurological disorders, including catatonia, agitation and aggression in individuals with dementia, schizophrenia, and epilepsy were assessed. There are no statistically demonstrated effects due to the fact that a small number of moderate-quality studies have been published; however, the combination of ECT technique with standard medication and care, can improve patient outcome. Furthermore, with regard to ECT, widespread and robust volume changes in both cortical and subcortical regions have been shown. Antidepressant response and volumetric increases appear to be limited by the specific neuroplasticity threshold of each patient.

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Increased subcortical region volume induced by electroconvulsive therapy in patients with schizophrenia

Shan

Zhang

Dong

et al. 2021

Eur Arch Psychiatry Clin Neurosci

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Efficacy, safety and tolerability of formula-based unilateral vs bilateral electroconvulsive therapy in the treatment of major depression: A randomized open label controlled trial

Cited by 17 publications

References 51 publications

Electroconvulsive Therapy and Age: Effectiveness, Safety and Tolerability in the Treatment of Major Depression among Patients under and over 65 Years of Age

Electroconvulsive Therapy and Age: Effectiveness, Safety and Tolerability in the Treatment of Major Depression among Patients under and over 65 Years of Age

Efficacy of electroconvulsive therapy as a potential first‑choice treatment in treatment‑resistant depression (Review)

Increased subcortical region volume induced by electroconvulsive therapy in patients with schizophrenia

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