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[Treating depressive disorders with continuation electroconvulsive therapy].

A Sartorius1, F A Henn

  • 1Zentralinstitut für Seelische Gesundheit, J5, Mannheim. sartorius@web.de

Der Nervenarzt
|July 14, 2005
PubMed
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Electroconvulsive therapy (ECT) is a first-line treatment for severe depression. This study advocates for broader use of continuation ECT (cECT) to maintain remission, addressing underutilization due to stigma and fear.

Area of Science:

  • Psychiatry
  • Neuroscience

Context:

  • Electroconvulsive therapy (ECT) is increasingly recognized as a first-line treatment for severe depressive disorders.
  • Despite its efficacy, ECT is underutilized as a continuation therapy after acute remission, with antidepressant medication often preferred.
  • Current practice guidelines inadequately address the use of continuation ECT (cECT) and maintenance ECT (mECT).

Purpose:

  • To propose guidelines for continuation ECT (cECT).
  • To examine key aspects of cECT, including indication, management, comedication, comorbidity, side effects, and costs.
  • To advocate for increased utilization of cECT based on recent evidence and therapeutic recommendations.

Summary:

  • This article reviews the current status of ECT in psychiatric practice, highlighting its renaissance as a first-line therapy for severe depression.

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  • It identifies the underuse of continuation ECT (cECT) and maintenance ECT (mECT) as a significant issue, often stemming from misconceptions and stigma.
  • The authors propose comprehensive guidelines for cECT, covering essential clinical considerations and arguing for its wider application in preventing relapse.

    • Impact:

    • Encourages a re-evaluation of cECT's role in long-term major depression management.
    • Aims to reduce the stigma associated with ECT and promote evidence-based treatment decisions.
    • Provides a framework for clinicians to confidently implement cECT, potentially improving patient outcomes and reducing relapse rates.