Efficacy of electroconvulsive therapy in bipolar versus unipolar major depression: a meta‐analysis

@article{Dierckx2012EfficacyOE,
  title={Efficacy of electroconvulsive therapy in bipolar versus unipolar major depression: a meta‐analysis},
  author={Bram Dierckx and Willemijn T Heijnen and Walter W. van den Broek and Tom K Birkenh{\"a}ger},
  journal={Bipolar Disorders},
  year={2012},
  volume={14}
}
Dierckx B, Heijnen WT, van den Broek WW, Birkenhäger TK. Efficacy of electroconvulsive therapy in bipolar versus unipolar major depression: a meta‐analysis. Bipolar Disord 2012: 14: 146–150. © 2012 The Authors. Journal compilation © 2012 John Wiley & Sons A/S. 
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Electroconvulsive therapy is equally effective in unipolar and bipolar depression.
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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.
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TLDR
It is concluded that ECT is an effective treatment for mania, unipolar, and bipolar depression, that unilateral and bilateral treatments are equally effective, and that no significant difference exists in the number of ECTs used to treat these disorders.
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Patients with bipolar depression tend to show more rapid clinical improvement with ECT than patients with unipolar depression.
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There was a large effect for BP patients to show more rapid clinical improvement and require fewer treatments than unipolar patients, and this could reflect a more rapid build up of anticonvulsant effects in BP patients.
Remission of symptoms in patients with unipolar and bipolar depression submitted to electroconvulsive therapy.
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ECT can benefit severely depressed patients resistant to pharmacological treatment and suggests that ECT could be used earlier in the treatment course of the depressed patient, as well as being efficacious in improving quality of life.
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The response of depressive symptoms to ECT was studied in 58 subjects who met DSM-III criteria for major depression, revealing a differential response, with alcoholism and schizophrenia having the most favorable outcomes.
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TLDR
Bilateral ECT is effective in relieving severe major depression andRemission rates are higher and occur earlier in psychotic depressed patients than in nonpsychotic depressed patients, supporting the argument that psychotic depression is a distinguishable nosological entity that warrants separate treatment algorithms.
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