Bifrontal versus bitemporal electroconvulsive therapy in severe manic patients
Related Experiment Video
Updated: Jul 2, 2026

Combined Transcranial Magnetic Stimulation and Electroencephalography of the Dorsolateral Prefrontal Cortex
Published on: August 17, 2018
Majid Barekatain1, Leila Jahangard, Mohammad Haghighi
1Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, Iran. barekatain@med.mui.ac.ir
Objectives:
To compare the efficacy and safety of moderate-dose bifrontal (BF) with low-dose bitemporal (BT) electroconvulsive therapy (ECT) in the treatment of patients with severe mania.
Methods:
In a parallel, double-blind, randomized clinical trial, 28 patients with severe mania admitted to a university hospital were assigned randomly to moderate-dose BF (n = 14) and low-dose BT (n= 14) ECT. The primary outcome measures included the Mini-Mental State Examination (MMSE) and the Young Mania Rating Scale (YMRS).
Results:
All patients received at least 6 sessions of ECT. The 2 groups did not show any difference in their baseline MMSE or YMRS scores (P > 0.05). There was a significant difference between the MMSE scores of the BF compared with the BT group after both the sixth ECT (P < 0.05) and final ECT treatments (P < 0.05). Young Mania Rating Scale scores did not differ between the 2 groups after either the sixth or the last ECT sessions (P > 0.05).
Conclusions:
Moderate-dose BF ECT was as effective as BT ECT but was associated with fewer cognitive side effects in the treatment of patients with severe mania.
Related Concept Videos
Electroconvulsive Therapy
Mania and Antimanic Drugs: Overview
Bipolar Disorder
Psychosis: Goals of Pharmacotherapy
