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Markedly suprathreshold right unilateral ECT versus minimally suprathreshold bilateral ECT: antidepressant and memory
W Vaughn McCall1, Aaron Dunn, Peter B Rosenquist
1Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine,Winston-Salem, North Carolina27127, USA. vmccall@wfubmc.edu
The Journal of ECT
|October 24, 2002
Summary
Right unilateral (RUL) electroconvulsive therapy (ECT) and bilateral (BL) ECT showed similar antidepressant response rates and transient memory side effects. Both RUL and BL ECT are justifiable first-line treatments for major depression.
Area of Science:
- Neuroscience
- Psychiatry
- Clinical Medicine
Background:
- Electroconvulsive therapy (ECT) is a treatment for severe depression.
- Right unilateral (RUL) ECT is often preferred due to fewer memory side effects compared to bilateral (BL) ECT.
Purpose of the Study:
- To compare the efficacy and memory side effects of RUL ECT at eight times seizure threshold (ST) versus BL ECT at 1.5 times ST.
- To evaluate antidepressant response and anterograde amnesia in patients with major depression.
Main Methods:
- Adults with major depression were randomly assigned to RUL ECT (8x ST) or BL ECT (1.5x ST).
- Mood and memory were assessed before, during, and up to 4 weeks after ECT.
- Forty patients received RUL ECT and 37 received BL ECT.
Main Results:
- Antidepressant response rates were similar between RUL (60%) and BL (73%) groups.
- Both treatments resulted in transient anterograde amnesia.
- No significant differences in mood or memory measures were observed between the groups at any time point.
Conclusions:
- RUL ECT at 8x ST and BL ECT at 1.5x ST yield comparable mood and memory effects.
- Both methods demonstrate acceptable antidepressant response rates and transient memory impairment.
- Neither treatment showed a clear advantage, supporting their use as first-line ECT techniques.