What is it about?
This paper clarifies the current evidence base regarding the efficacy and tolerability of the common practice of giving electroconvulsive therapy (ECT) at reduced intervals following the completion of a standard course of ECT for major depression, to reduce the risk of a relapse.
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Why is it important?
This is the first meta-analysis to include only randomised controlled studies that broadly reflect the way in which continuation ECT is given in the real world for major depression relapse prevention - i.e. at an adequate dose and in combination with antidepressant medication. It shows that continuation ECT, in combination with antidepressant medication, is associated with a lower risk of relapse than medication alone.
Perspectives
Previous meta-analyses on this topic have included an RCT using low-dose right unilateral ECT (an underpowered form of the treatment not recommended by experts), and one comparing continuation ECT alone with medication alone. The experimental conditions did not reflect how ECT is given in routine practice and their outcomes cannot be expected to contribute to answering the question of whether continuation ECT, as recommended, is effective.
Dr Richard Braithwaite
Sussex Partnership NHS Foundation Trust
Read the Original
This page is a summary of: Continuation electroconvulsive therapy combined with pharmacotherapy for depression relapse prevention: A systematic review and meta-analysis, Psychological Medicine, January 2025, Cambridge University Press,
DOI: 10.1017/s0033291725101608.
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