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Related Experiment Videos

Does power matter with ECT?

Michel R Ju1, Tom K Birkenhäger, Walter W van den Broek

  • 1Department of Psychiatry, Erasmus Medical Centre, PO Box 2040, 3000 CA Rotterdam, The Netherlands.

Journal of Affective Disorders
|November 1, 2005
PubMed
Summary

Approximately 22% of inpatients with depression require high-output electroconvulsive therapy (ECT) for adequate seizure induction. The response rates for high-output ECT are comparable to standard-output ECT, suggesting its utility in clinical practice.

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Area of Science:

  • Neurology
  • Psychiatry
  • Medical Devices

Background:

  • Electroconvulsive therapy (ECT) is a treatment for severe depression.
  • Determining optimal ECT energy levels is crucial for effective treatment.
  • High-output ECT may be necessary for certain patient populations.

Purpose of the Study:

  • To determine the incidence of depressed inpatients requiring high-output ECT.
  • To compare the treatment response of patients receiving high-output ECT versus standard-output ECT.

Main Methods:

  • Retrospective review of 59 inpatients treated with bilateral ECT (January 2001-January 2004).
  • Diagnosis of major depression based on DSM-IV criteria.
  • Response and remission assessed using the Hamilton Rating Scale for Depression (HRSD).

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Main Results:

  • 13 out of 59 patients (22%) required high-output ECT.
  • High-output ECT patients needed significantly more treatments (16.4±7.1 vs. 10.4±4.5; p=0.01).
  • Response rates were 67% for standard-output and 85% for high-output ECT (not statistically significant).

Conclusions:

  • A significant proportion of depressed inpatients require high-output bilateral ECT for seizure induction.
  • The efficacy of high-output ECT is similar to standard-output ECT.
  • High-output ECT devices should be available for routine clinical use.