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Cost and benefit in the choice of ECT schedule

Twice versus three times weekly ECT

Published online by Cambridge University Press:  03 January 2018

Baruch Shapira ,
Nurith Tubi ,
Heinz Drexler ,
David Lidsky ,
Avraham Calev  and
Bernard Lerer
Baruch Shapira
Affiliation:
Depression Treatment Unit, Herzog Hospital, and Department of Psychiatry, Hebrew University–Hadassah Medical School, Jerusalem
Nurith Tubi
Affiliation:
Depression Treatment Unit, Herzog Hospital Jerusalem
Heinz Drexler
Affiliation:
Depression Treatment Unit, Herzog Hospital Jerusalem
David Lidsky
Affiliation:
Depression Treatment Unit, Herzog Hospital Jerusalem
Avraham Calev
Affiliation:
Depression Treatment Unit, Herzog Hospital Jerusalem
Bernard Lerer*
Affiliation:
Biological Psychiatry Laboratory, Hadassah–Hebrew University Medical Center, and Department of Psychiatry, Hebrew University–Hadassah Medical School, Jerusalem
*
Professor Bernard Lerer, Biological Psychiatry Laboratory, Department of Psychiatry, Hadassah – Hebrew University Medical Center, Kiryat Hadassah, PO Box 12000, Jerusalem 91120, Israel. Fax: 972-2-434434; e-mail: [email protected]
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Abstract

Background

We compared the anti-depressant and cognitive effects of up to eight sessions of bilateral, brief pulse electroconvulsive therapy (ECT) administered twice (ECT x 2) or three times weekly (ECT x 3), to confirm that ECT x 3 acts more rapidly although the two schedules are equivalent in antidepressant outcome, and to establish whether ECT x 3 is indeed associated with more severe memory impairment.

Method

Patients with major depression, endogenous subtype were randomly assigned to ECT x 3 or ECT x 2 plus one simulated ECT per week, both up to a maximum of eight real ECT. Depression was evaluated by the Hamilton Depression Scale the day after each treatment and cognitive function by a test battery administered before and after the ECT series and at one month follow-up.

Results

Assessed categorically or parametrically, there was no significant difference in antidepressant outcome between the two schedules. Rate of response was significantly more rapid with ECT x 3 but was associated with more severe memory impairment.

Conclusions

Twice weekly administration is an optimum schedule for bilateral ECT unless clinical indications require the more rapid antidepressant effect of three times weekly treatment.

Type
Papers
Information
The British Journal of Psychiatry , Volume 172 , Issue 1 , January 1998 , pp. 44 - 48
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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