Does lithium prevent relapse following successful electroconvulsive therapy for major depression? A systematic review and meta‐analysis

@article{Lambrichts2021DoesLP,
  title={Does lithium prevent relapse following successful electroconvulsive therapy for major depression? A systematic review and meta‐analysis},
  author={Simon Lambrichts and Johan Detraux and Kristof Vansteelandt and Axel Nordenskj{\"o}ld and Jasmien Obbels and Didier Schrijvers and Pascal Sienaert},
  journal={Acta Psychiatrica Scandinavica},
  year={2021},
  volume={143}
}
The risk of relapse following successful antidepressant treatment, including electroconvulsive therapy (ECT), is substantial. Lithium has been suggested to effectively prevent relapse, yet data remain limited and inconclusive. We performed a systematic review and meta‐analysis to examine the efficacy of continuation treatment with lithium in preventing relapse following a successful acute course of ECT in patients with major depression, in comparison to continuation treatment without lithium… 

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Relapse Prevention

References

SHOWING 1-10 OF 55 REFERENCES

Lithium for post-electroconvulsive therapy depressive relapse prevention: a consideration of the evidence.

There is strong evidence that lithium can help prevent relapses in the first 6 months after index ECT, however, there are several unanswered questions about its use post-ECT, including optimal target blood level, duration of use, and concomitant antidepressant choice.

Relapse Following Successful Electroconvulsive Therapy for Major Depression: A Meta-Analysis

The largest evidence base for efficacy in post-ECT relapse prevention exists for tricyclic antidepressants and published evidence is limited or non-existent for commonly used newer antidepressants or popular augmentation strategies.

Continuation pharmacotherapy in the prevention of relapse following electroconvulsive therapy: a randomized controlled trial.

It is indicated that without active treatment, virtually all remitted patients relapse within 6 months of stopping ECT, and the combination of nortriptyline and lithium is more effective, but the relapse rate is still high, particularly during the first month of continuation therapy.

Continuation electroconvulsive therapy vs pharmacotherapy for relapse prevention in major depression: a multisite study from the Consortium for Research in Electroconvulsive Therapy (CORE).

Both C-ECT and C-Pharm were shown to be superior to a historical placebo control, but both had limited efficacy, with more than half of patients either experiencing disease relapse or dropping out of the study.

Predictors of Time to Relapse/Recurrence after Electroconvulsive Therapy in Patients with Major Depressive Disorder: A Population-Based Cohort Study

Within the first years after ECT, relapses/recurrences leading to hospitalisation or suicide are common, while treatment with lithium might be beneficial, while benzodiazepines, antipsychotics, or continuation ECT does not seem to significantly reduce the risk of relapse/recurrence.

Improving Relapse Prevention After Successful Electroconvulsive Therapy For Patients With Severe Depression: Completed Audit Cycle Involving 102 Full Electroconvulsive Therapy Courses in West Sussex, United Kingdom

Not all psychotropic medication prescribing for patients receiving ECT for depression followed available and current guidance or consensus, and more needs to be done to understand the reasons for the reluctance to use lithium if relapse rates after ECT are to improve.

Lithium Continuation Therapy Following Electroconvulsive Therapy

The trial confirms the high rate of relapses after ECT and suggests that lithium considerably reduces this morbidity and it is suggested that ECT without continuation therapy is not a satisfactory treatment of depressive illness.

Electroconvulsive therapy in the continuation and maintenance treatment of depression: Systematic review and meta-analyses

The preliminary and limited evidence suggests the modest efficacy of continuation electroconvulsive therapy and maintenance electro Convulsive therapy with concomitant pharmacotherapy in preventing relapse and recurrence of depressive episodes for 1 year after the remission of index episode with the acute course of electroconvulsion therapy.

Continuation Electroconvulsive Therapy With Pharmacotherapy Versus Pharmacotherapy Alone for Prevention of Relapse of Depression: A Randomized Controlled Trial

The hypothesis that relapse prevention with continuation electroconvulsive therapy (ECT) plus pharmacotherapy is more effective than pharmacotherapy alone after a course of ECT for depression is tested.
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