New Electroconvulsive Method, Milder Side-Effects
> 6/3/2008 3:36:32 PM

Electroconvulsive therapy (ECT) has a negative image, partly because of a history of abusive use on uncooperative patients and partly because of disturbing portrayals in film. Modern ECT is given voluntarily and has shown great success in treating major depression, especially in treatment resistent patients, but many patients are still wary of the procedure. One concrete basis for their worry is that ECT causes noticeable side-effects, including memory loss and temporary cognitive impairment. This concern may be alleviated by a new method tested by  Harold Sackeim and reported in the April issue of the journal Brain Stimulation.

Sackeim recruited 90 patients for a double-blind study comparing ultrabrief ECT against the standard-length pulse. Cognition, memory, and depression were evaluated before, during, immediately after, 2 months after, and 6 months after the treatment. Amazingly, the new ultrabrief pulses resulted in a 73% depression remission rate whereas the traditional method only achieved a 65% remission rate.

In addition to improving remission rates, the ultrabrief pulses also came with less severe side-effects at all evaluation periods and for all measured abilities. Ultrabrief patients reported less short and long-term retrograde amnesia, and performed better on every cognitive task.

Ultrabrief pulses were more effective than the traditional method in this experiment, and while this advantage may not turn out to be significant in future studies, the evidence strongly suggests that ultrabrief pulses will not be less effective than what doctors are currently using. Therefore, the additional benefit of milder side-effects has a good chance of making this method a significant improvement. Any improvement will be helpful, because it will further differentiate modern ECT from its controversial past.

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