Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis

@article{Geddes2003EfficacyAS,
  title={Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis},
  author={J. Geddes},
  journal={The Lancet},
  year={2003},
  volume={361},
  pages={799-808}
}
BACKGROUND We aimed to review published work for the efficacy and safety of electroconvulsive therapy (ECT) with simulated ECT, ECT versus pharmacotherapy, and different forms of ECT for patients with depressive illness. METHODS We designed a systematic overview and meta-analysis of randomised controlled trials and observational studies. We obtained data from the Cochrane Collaboration Depressive Anxiety and Neurosis and Schizophrenia Group Controlled trial registers, Cochrane Controlled… Expand

Paper Mentions

Observational Clinical Trial
The main purpose of this study is to determine whether electroconvulsive therapy (ECT) causes any structural or functional brain changes and thus indicating its mechanism of action. The… Expand
ConditionsCognitive Dysfunction, Depression, Depressive Disorder, (+1 more)
InterventionOther
Observational Clinical Trial
The study aims to use machine learning to predict the occurrence of episodic and autobiographical memory deficits as well as treatment response following a course of… Expand
ConditionsCognitive Impairment, Depression, ECT, (+1 more)
InterventionDevice, Drug
Observational Clinical Trial
The main purpose of this study is to determine whether electroconvulsive therapy (ECT) causes any structural or functional brain changes and thus indicating its mechanism of action. The… Expand
ConditionsDepression, Depressive Disorder, Depressive Disorder, Major
Efficacy and Safety of Electroconvulsive Therapy in the Treatment of Bipolar Disorder: A Systematic Review
TLDR
There are no studies with adequate methodology on the treatment of BPD with ECT, and the lack of scientific evidence contrasts with broad anecdotal clinical experience that suggests that ECT is an important tool in the treatmentof BPD, especially in more severe or refractory cases. Expand
Review: electroconvulsive therapy may be an effective short term treatment for people with depression
  • M. Bauer
  • Medicine
  • Evidence-based mental health
  • 2003
TLDR
The reviewers searched Medline, Embase, the Cochrane Collaboration Depressive Anxiety and Neurosis and Schizophrenia Group Controlled Trial Registers, Cochrane Controlled Trials Register, Biological Abstracts, CINAHL, LILACS, PsycInfo, SIGLE, reference lists, and specialist textbooks. Expand
Influence of an adjuvant antidepressant on the efficacy of electroconvulsive therapy: A systematic review and meta-analysis
TLDR
A systematic review and meta-analysis revealed a significant advantage of adjuvant antidepressants versus placebo and recommended the routine use of an adequately dosed antidepressant during electroconvulsive therapy for major depression. Expand
Effects of electroconvulsive therapy on cognitive functioning in patients with depression: protocol for a systematic review and meta-analysis
TLDR
A meta-analysis is conducted to examine the effects of ECT on cognition in persons with depression and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to assess the strength of evidence. Expand
Systematic review and meta-analysis of bifrontal electroconvulsive therapy versus bilateral and unilateral electroconvulsive therapy in depression
  • R. Dunne, D. McLoughlin
  • Psychology, Medicine
  • The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry
  • 2012
TLDR
Bifrontal ECT is not more effective than BT or RUL ECT but may have modest short-term benefits for specific memory domains and BF ECT has potential advantages, but given longer experience with BT and RUL, bif prefrontal ECT requires better characterization. Expand
Objective Cognitive Performance Associated with Electroconvulsive Therapy for Depression: A Systematic Review and Meta-Analysis
TLDR
Cognitive abnormalities associated with ECT are mainly limited to the first 3 days posttreatment, and Pretreatment functioning levels are subsequently recovered. Expand
The effectiveness of electroconvulsive therapy: A literature review
TLDR
The cost-benefit analysis for ECT is so poor that its use cannot be scientifically justified, and there are no placebo-controlled studies evaluating the hypothesis that ECT prevents suicide, and no robust evidence from other kinds of studies to support the hypothesis. Expand
BDNF blood levels after electroconvulsive therapy in patients with mood disorders: A systematic review and meta-analysis
TLDR
The meta-analysis indicates that, similar to pharmacological interventions, peripheral BDNF increases after ECT treatment, and the lack of correlation between BDNF increasing and depression improvement suggests that ECT induces neurotrophic effects regardless of clinical response in depression. Expand
Adjunctive Nonconvulsive Electrotherapy for Patients with Depression: a Systematic Review
  • Dong-Bin Cai, Hua-Rong Zhou, +6 authors Wei Zheng
  • Medicine
  • Psychiatric Quarterly
  • 2021
TLDR
The currently available limited evidence from 3 studies suggests that NET as an adjunctive treatment may be a safe, well-tolerated, effective therapy for depression without serious neurocognitive impairments. Expand
Efficacy and safety of electroconvulsive therapy plus medication versus medication alone in acute mania: A meta-analysis of randomized controlled trials
TLDR
The results of this meta-analysis suggest that ECT-combo was significantly superior to Med-alone in efficacy and well-tolerated in the acute treatment of mania, but larger studies with randomized, double-blind design, and standardized treatment regimens are still warranted due to the high heterogeneity of studies included in the present meta- analysis. Expand
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TLDR
The present study found ECT to be superior to paroxetine in medication‐resistant major depression, in terms of both degree and speed of response. Expand
Effect of ECT on mortality and clinical outcome in geriatric unipolar depression.
TLDR
Patients who received ECT were more likely to exhibit psychomotor retardation and to have had prior courses of ECT than those who did not receive ECT and to demonstrate greater clinical improvement than those treated only with pharmacotherapy. Expand
Continuation pharmacotherapy in the prevention of relapse following electroconvulsive therapy: a randomized controlled trial.
TLDR
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
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Electroconvulsive therapy was effective in depression associated with delusions and in depressionassociated with retardation and showed a significantly greater improvement than simulated treatment. Expand
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TLDR
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TLDR
Electroconvulsive therapy is still considered to be the treatment of choice for severe depression, whereas the combination of low doses of phenelzine and amitriptyline are ineffective, and this treatment modality needs further investigation. Expand
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TLDR
For a quarter century, the most widely accepted view has been that the elicitation of a generalized seizure provides both the necessary and sufficient conditions for the antidepressant properties of ECT, and there have been longstanding indications that electrical dosage and/or waveform characteristics are related to the cognitive side effects of EECT. Expand
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TLDR
A clinical trial is reported in which a comparison was made between the effects of electro-convulsive therapy and phenelzine (“Nardil”) in the treatment of depressive illness, and it is concluded that pheneizine is much inferior to electro- Convulsive therapy. Expand
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Mortality in depressed patients treated with electroconvulsive therapy and antidepressants.
TLDR
The electroconvulsive therapy group had a significantly lower mortality than the inadequate antidepressant treatment group and the group that received neither ECT nor antidepressants, which underscores the importance of adequate treatment of depression, especially in the older man. Expand
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