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Retrograde amnesia following electroconvulsive therapy for depression: propensity score analysis
Ana Jelovac1, Sabine Landau2, Gabriele Gusciute1
1Department of Psychiatry, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland.
Bjpsych Open
|April 4, 2025
Summary
Electroconvulsive therapy (ECT) can cause retrograde amnesia, affecting autobiographical memory recall. This memory impairment is more pronounced with bitemporal ECT and may persist long-term.
Area of Science:
- Cognitive Neuroscience
- Psychiatry
- Neuropsychology
Background:
- Retrograde amnesia for autobiographical memories is a frequently reported side effect of electroconvulsive therapy (ECT).
- Objective differences in cognitive performance between ECT-exposed and unexposed patients with depression remain unclear.
- Understanding the long-term cognitive effects of different ECT techniques is crucial for patient care.
Purpose of the Study:
- To investigate the association between electroconvulsive therapy (ECT) exposure and retrograde amnesia.
- To compare objective autobiographical memory performance in patients receiving bitemporal or high-dose right unilateral ECT versus controls.
- To assess short- and long-term retrograde amnesia following ECT in patients with depression.
Main Methods:
- Propensity score analysis comparing ECT-exposed patients (bitemporal or high-dose right unilateral) with non-exposed depressed inpatients.
- Assessment of autobiographical memory recall consistency at short-term (within days) and long-term (3 months) follow-up.
- Inclusion of patients receiving psychotropic pharmacotherapy and routine inpatient care.
Main Results:
- Statistically significant reductions in autobiographical memory recall consistency were observed in both bitemporal and high-dose right unilateral ECT groups.
- The reduction in memory recall consistency was substantially more pronounced in the bitemporal ECT group compared to right unilateral ECT.
- Evidence suggests retrograde amnesia for events preceding ECT occurs with commonly used techniques and may persist.
Conclusions:
- Electroconvulsive therapy (ECT), particularly bitemporal, is associated with objective retrograde amnesia for autobiographical memories.
- This memory impairment can be present both shortly after and up to three months following ECT.
- Retrograde amnesia represents a potentially persisting adverse cognitive effect of established ECT techniques.
