Electroconvulsive therapy (ECT) is more effective in treating treatment-resistant depression compared to pharmacological treatment, though remission rates between the two therapies are similar.
Helle K. Schoeyen, MD, PhD, of Stavanger University Hospital, Stavanger, Norway and Ute Kessler, MD, of Haukeland University Hospital, Belgen, Norway, examined 73 bipolar disorder patients with treatment-resistant depression. Patients were randomized to either ECT or algorithm-based pharmacological treatment. ECT was given three sessions weekly for up to six weeks.
Mean scores based on various depression assessment scales at the end of the six-week treatment period were lower for the ECT group than for the pharmacological treatment group, the researchers reported in the American Journal of Psychiatry.
Scores in the ECT group were 6.6 points lower on the Montgomery-Åsberg Depression Rating Scale (SE=2.05, 95% CI=2.5–10.6) and 9.4 points lower on the 30-item version of the Inventory of Depressive Symptomatology–Clinician-Rated (SE=2.49, 95% CI=4.6–14.3).
Although the response rate was significantly higher in the ECT group than in the group that received pharmacological treatment (73.9% versus 35.0%), the remission rate did not differ between the groups (34.8% versus 30.0%).
Electroconvulsive therapy (ECT) is regarded by many clinicians as the most effective treatment for treatment-resistant bipolar depression, but no randomized controlled trials have been conducted, to the authors’ knowledge. They compared efficacy measures of ECT and algorithm-based pharmacological treatment in treatment-resistant bipolar depression.
This multicenter, randomized controlled trial was carried out at seven acute-care psychiatric inpatient clinics throughout Norway and included 73 bipolar disorder patients with treatment-resistant depression. The patients were randomly assigned to receive either ECT or algorithm-based pharmacological treatment. ECT included three sessions per week for up to 6 weeks, right unilateral placement of stimulus electrodes, and brief pulse stimulation.