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

  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},
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… Expand
2 Citations
Effectiveness of maintenance electroconvulsive therapy—Evidence from modifications due to the COVID‐19 pandemic
This study strongly corroborates the effectiveness of c‐/m‐ECT in a real‐world population and indicates that patients with shorter time since index ECT seem to be at high risk for severe clinical deterioration in the case of treatment discontinuation or reduction. Expand
Relapse following bitemporal and high‐dose right unilateral electroconvulsive therapy for major depression
Long-term outcome following high-dose right unilateral ECT does not differ from bitemporal ECT, and prognosis is particularly favourable in older adults, psychotic depression and patients maintained on lithium. Expand


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. Expand
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. Expand
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. Expand
Treatment of unipolar depression following electroconvulsive therapy. Relapse rate comparisons between lithium and tricyclics therapies following ECT.
It is concluded that ECT followed by either lithium or a tricyclic antidepressant is a more effective treatment for unipolar depression than ECT alone. Expand
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. Expand
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. Expand
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. Expand
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. Expand
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. Expand
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. Expand