Less memory complaints with reduced stimulus dose during electroconvulsive therapy for depression.

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Medicine

Background:

• Electroconvulsive therapy (ECT) is a recognized treatment for major depression.
• Cognitive adverse events, particularly subjective memory worsening, are a concern with ECT.
• The electrical stimulus dose in ECT is a key factor influencing these adverse events.

Purpose of the Study:

• To investigate the impact of reduced electrical stimulus doses on subjective memory worsening in patients undergoing ECT for major depression.
• To determine if lowering the ECT stimulus dose affects the antidepressant efficacy.

Main Methods:

• A retrospective register-based study compared patients receiving high-dose versus lower-dose ECT.
• The primary outcome was subjective memory worsening.
• The secondary outcome was the change in depressive symptom severity.

Main Results:

• Subjective memory worsening occurred in 44% of the high-dose group versus 25% in the lower-dose group (p=0.014).
• No significant difference in antidepressant effect was observed between the groups.
• 154 patients were included: 57 in the high-dose group and 97 in the lower-dose group.

Conclusions:

• Reducing ECT stimulus doses significantly decreases the incidence of subjective memory worsening.
• Lowering the electrical charge does not compromise the antidepressant effectiveness of ECT.
• This suggests a potential optimization of ECT protocols to improve patient tolerability.