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Related Experiment Videos

Long-term outcome after ECT for catatonic depression.

C M Swartz1, V Morrow, L Surles

  • 1Department of Psychiatry, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9642, USA. ectdoc@pol.net

The Journal of ECT
|August 31, 2001
PubMed
Summary

Electroconvulsive therapy (ECT) followed by antimelancholic medication (AMM) significantly improved long-term outcomes for major depression with catatonic features compared to other treatments. AMM use was associated with better functioning and reduced mortality.

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Area of Science:

  • Psychiatry
  • Neuroscience
  • Clinical Medicine

Background:

  • Major depression with catatonic features is a severe condition requiring effective long-term management strategies.
  • Electroconvulsive therapy (ECT) is an established treatment for catatonic depression, but its long-term efficacy depends on post-hospitalization care.

Purpose of the Study:

  • To report the long-term course of major depression with catatonic features after inpatient electroconvulsive therapy (ECT).
  • To compare outcomes for patients receiving antimelancholic medication (AMM) versus those not receiving AMM after ECT.

Main Methods:

  • A follow-up study involving telephone interviews and ratings conducted 3-7 years post-ECT for 19 patients with catatonic depression.
  • Patients received left anterior right temporal brief-pulse ECT.

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  • Antimelancholic medications (AMM) were defined by specific criteria, including lithium, tricyclics, bupropion, and venlafaxine, excluding SSRIs.

    • Main Results:

    • Ten of 13 patients discharged on AMM showed good long-term function with minimal rehospitalization.
    • None of the six patients not on AMM achieved similar outcomes (p = 0.004).
    • The AMM group had no deaths, while three patients in the other group died from cardiopulmonary causes (p = 0.015).

    Conclusions:

    • ECT followed by AMM generally results in good long-term outcomes for catatonic depression, superior to treatment without AMM.
    • Long-term use of benzodiazepines for catatonia remains speculative due to a lack of supporting long-term studies.