Acute antidepressant effects of right unilateral ultra-brief ECT: A double-blind randomised controlled trial

作者：Mayur Prashanth^*; Byth Karen; Harris Anthony

来源：Journal of Affective Disorders, 2013, 149(1-3): 426-429.

DOI：10.1016/j.jad.2012.12.005

• Ultra-brief right unilateral ECT
• Brief pulse right unilateral ECT
• Severe depression
• Antidepressant effects

Background: Shortening the pulse width to 0.3 ms holds neurophysiological and clinical promise of making ECT safer by limiting cognitive side effects. However, the antidepressant effects of right ultra-brief unilateral ECT are under contention. In an acute ECT course, antidepressant equivalence of ultra-brief right unilateral ECT to the high-dose brief pulse right unilateral ECT was investigated.
Methods: Severely depressed patients were randomised to 1 ms-brief pulse (n=18) or 0.3 ms ultra-brief pulse (n=17) right unilateral ECT, both at high-dose (6 times threshold stimulus dose) given thrice weekly. Depression severity was measured using the Montgomery Asberg Depression Rating Scale at baseline, after 8 treatments and after the acute course of ECT.
Results: Depression severity declined equally in both groups: F (1.27,41.97)=0.31, p=0.63. Median time in days to remission (95%CI) was in brief pulse ECT: 26 (18.6-33.4) and ultra-brief pulse ECT:28 (17.9-38.0).
Limitation: The small sample study in the study increases the likelihood of type 2 error.
Conclusion: In severe depression, high-dose ultra-brief right unilateral ECT appears to show matching acute antidepressant response to an equally high-dose brief pulse right unilateral ECT.

• 出版日期2013-7