Efficacy of ECT in Depression: A Meta-Analytic Review

  title={Efficacy of ECT in Depression: A Meta-Analytic Review},
  author={Daniel Pagnin and Val{\'e}ria de Queiroz and Stefano Pini and Giovanni Battista Cassano},
  journal={The Journal of ECT},
Summary: This study analyzed the efficacy of electroconvulsive therapy (ECT) in depression by means a meta-analytic review of randomized controlled trials that compared ECT with simulated ECT or placebo or antidepressant drugs and by a complementary meta-analytic review of nonrandomized controlled trials that compared ECT with antidepressants drugs. The review revealed a significant superiority of ECT in all comparisons: ECT versus simulated ECT, ECT versus placebo, ECT versus antidepressants… 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
ConditionsDepression, Depressive Disorder, Depressive Disorder, Major
The Sham ECT Literature: Implications for Consent to ECT
  • C. Ross
  • Medicine, Psychology
  • Ethical Human Psychology and Psychiatry
  • 2006
The author reviewed the placebo-controlled literature on electroconvulsive therapy (ECT) for depression. No study demonstrated a significant difference between real and placebo (sham) ECT at 1 monthExpand
Electroconvulsive Therapy for Depression: A Review of the Quality of ECT versus Sham ECT Trials and Meta-Analyses
The quality of most SECT–ECT studies is so poor that the meta-analyses were wrong to conclude anything about efficacy, either during or beyond the treatment period, and its use should be immediately suspended. Expand
Sham electroconvulsive therapy studies in depressive illness: a review of the literature and consideration of the placebo phenomenon in electroconvulsive therapy practice.
The sham ECT literature is reviewed in detail, and the author discusses possible mechanisms by which sham-treated patients improved, and some information regarding ECT response of depressive subtypes that informs the modern ECT practitioner. Expand
Is Electroconvulsive Therapy for Depression More Effective Than Placebo? A Systematic Review of Studies Since 2009
Background: A 2010 review of studies, previous reviews and meta-analyses found minimal evidence that electroconvulsive therapy (ECT) for depression was more effective than placebo during theExpand
Pharmacological and combined interventions for the acute depressive episode: focus on efficacy and tolerability
Although recent meta-analyses suggest sertraline and escitalopram might have increased efficacy/tolerability, other studies and large pragmatic trials have not found these to be superior to other antidepressant drugs and no superior drug was identified in terms of cost-effectiveness. Expand
A systematic review and meta-analysis of trials of treatment of depression from India
The available data support the superiority of antidepressants over placebo and that of ECT over antidepressants in the Indian context. Expand
Effects of Low-Dose Ketamine on the Antidepressant Efficacy and Suicidal Ideations in Patients Undergoing Electroconvulsive Therapy.
Low-dose ketamine (0.3 mg/kg) could modulate the antidepressant efficacy of ECT via accelerating the onset of its effects and reducing the number of E CT sessions required to obtain response, remission, and SI reduction, without influencing the relapse rates in remitting patients after ECT treatment. Expand
ECT in schizophrenia: a review of the evidence
From the review, it can be concluded that ECT is not only is beneficial as an augmenting strategy in treatment-resistant schizophrenia but also can be used effectively in patients with schizophrenia in various other situations. Expand
Antidepressants versus placebo in major depression: an overview
  • Arif Khan, W. Brown
  • Medicine
  • World psychiatry : official journal of the World Psychiatric Association
  • 2015
Although the early antidepressant trials which included severely ill and hospitalized patients showed substantial drug‐placebo differences, these robust differences have not held up in the trials ofExpand
Placebo eff ects in psychiatry: mediators and moderators.
It is suggested that predictors of the placebo response are still to be discovered, the response probably has more than one mediator, and that different and distinct moderators are probably what cause the placebo responded within psychiatry and beyond. Expand


Efficacy of ECT: a meta-analysis.
The authors analyzed several rigorously controlled studies that compared the efficacy of ECT with that of simulated ECT, placebo, and antidepressants, showing ECT's clear superiority over all these other forms of treatment for severe depression. Expand
Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis
A systematic overview and meta-analysis of randomised controlled trials and observational studies for the efficacy and safety of electroconvulsive therapy with simulated ECT, ECT versus pharmacotherapy, and different forms of ECT for patients with depressive illness found ECT is an effective short-term treatment for depression. Expand
Electroconvulsive therapy vs. paroxetine in treatment‐resistant depression — a randomized study
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
The treatment of depression: electroconvulsive therapy v antidepressants: a naturalistic evaluation of 1,495 patients.
Abstract Electroconvulsive therapy (ECT), adequate antidepressant, inadequate antidepressant, and neither treatment were compared by reviewing charts of 1,495 patients admitted to our hospital over aExpand
A controlled comparison of amitriptyline and electroconvulsive therapy in the treatment of depression.
There was no appreciable difference after one month of treatment between the therapeutic effects of amitriptyline and ECT. Expand
Who responds to electroconvulsive therapy? A comparison of effective and ineffective forms of treatment.
ECT is a viable treatment option for patients with major depression regardless of the presence or absence of psychosis, retardation and/or agitation, and the findings cast doubt on the utility of these depression subtypes in predicting ECT response. Expand
A controlled comparison of simulated and real ECT.
  • J. Lambourn, D. Gill
  • Psychology, Medicine
  • The British journal of psychiatry : the journal of mental science
  • 1978
The results suggest that the ECT pre-treatment procedure has an important therapeutic effect, and casts some doubt on current views of the effectiveness of electro-convulsive therapy in general, and of brief pulse unilateral ECT in particular. Expand
A Comment on the Efficacy of Unilateral Versus Bilateral ECT.
Ten studies comparing the efficacy of unilateral versus bilateral electroconvulsive therapy (ECT) were reexamined. Three different methods of meta-analysis applied to the combined results revealedExpand
Depression treated with imipramine and ECT: the DeCarolis study reconsidered.
The authors reevaluate a large prospective Italian study (437 patients) that compared high-dose imipramine with ECT treatment in the treatment of depression. The superiority of ECT was evident amongExpand
An efficacy study of electroconvulsive therapy and antidepressants in the treatment of primary depression.
It is found that the type of treatment is not important for the unipolar patient, whereas a combination of ECT and antidepressants lengthens the time to rehospitalization of the bipolar patient. Expand