Short-Term, Long-term Effects of ECT on Cognitive Functioning

ECT wires on bed
ECT wires on bed
Cognitive adverse effects in patients who undergo bilateral ECT are transient.

For patients with depressive disorders, bilateral electroconvulsive therapy (ECT) has short-term negative cognitive effects, but functioning recovers after 6 months, according to results published in the Journal of Affective Disorders.

The study included participants with depression (n=48) and healthy control patients (n=19). Each participant underwent cognitive tests, including tests of working memory, verbal fluency, visuospatial abilities, verbal/visual memory, learning, processing speed, inhibition, attention, task-switching, and premorbid IQ. Participants underwent cognitive assessments at baseline (n=43), after 10 ECT sessions (posttreatment, n=39), and 6 months after the tenth ECT session (follow-up, n=25). Healthy control patients underwent cognitive assessment at baseline, and again after 5 weeks.

The researchers observed a global significant interaction effect between time and cognitive test in their multivariate mixed model (F=14.08; P <.001), which indicated that ECT had different effects over time on different cognitive variables.

Participants with depression had adverse effects on verbal memory and learning and verbal fluency posttreatment. However, after 6 months of follow-up, participants with depression showed significant improvement from their posttreatment scores, indicating that the effect was not permanent.

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The results indicated that ECT did have a significant effect on depression scores, with significant decreases seen between baseline and posttreatment and baseline and follow-up (both P <.001).

“[L]ong term…no negative effects were seen compared to baseline cognitive functioning. These results might reduce the reluctance in some patients and practitioners to consider bilateral ECT as a safe and effective treatment for refractory depression,” the researchers wrote.


Nuninga JO, Claessens TFI, Somers M, et al. Immediate and long-term effects of bilateral electroconvulsive therapy on cognitive functioning in patients with a depressive disorder. J Affect Disord. 2018;238:659-665.