Conference paper
IS ELECTROCONVULSIVE THERAPY ANY MORE EFFECTIVE THAN SIMULATED ELECTROCONVULSIVE THERAPY IN TREATMENT-RESISTANT DEPRESSION?
Alexander Bow
; University of Cambridge, Emmanuel College, Cambridge, UK
Abstract
Background: Electroconvulsive therapy (ECT) fell out of favour towards the end of the 20th century with the advent of effective
and well-tolerated antidepressants. It is now experiencing somewhat of a ‘renaissance’ in England, with an 11 percent increase
in the number of ECT treatments carried out in 2015-16 compared with 2012-13, which represents approximately 2,000
additional treatments.
Aims: This paper seeks to examine clinical trials comparing the efficacy of real ECT with simulated ECT in treatment-resistant
depression (TRD) to determine whether the resurgence of ECT in recent years is justified.
Methods: A PubMed search was performed to identify clinical trials comparing real ECT with simulated ECT. 6 trials met the
inclusion criteria. These were then analysed, and their methodology assessed.
Results: 5 out of the 6 trials found real ECT to have a greater antidepressant effect than simulated ECT. The trial that showed no
significant difference used a unilateral electrode placement. Analysis revealed significant weaknesses in the trials.
Conclusions: There is clear evidence that real ECT has a greater antidepressant effect than simulated ECT when a bilateral
electrode placement is used, despite the weaknesses identified in the trials. Continued use of ECT to treat TRD in England and other countries should be encouraged. Further research is needed to better understand its mechanism of action and refine the techniques used.
Keywords
electroconvulsive therapy; simulated; depression; ECT
Hrčak ID:
262978
URI
Publication date:
21.11.2018.
Visits: 396 *