A Prospective, Randomized, Double-blind Comparison of Bilateral and Right Unilateral Electroconvulsive Therapy at Different Stimulus Intensities

Sackeïm, Harold A.; Prudic, Joan; Devanand, D. P.; Nobler, Mitchell S.; Lisanby, Sarah H.; Peyser, Shoshana; Fitzsimons, Linda; Moody, Bobba J.; Clark, Jenifer

doi:10.1001/archpsyc.57.5.425

Cited by 736 publications

(533 citation statements)

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“…For decades, BL ECT represented the gold standard with respect to ECT efficacy, and the equivalence of RUL ECT was uncertain (Abrams, 1986). Based on accumulating evidence that the efficacy of RUL ECT is strongly influenced by dosage relative to seizure threshold, highly effective forms of RUL ECT are available (McCall et al, 2000;Sackeim et al, 2000). Indeed, recent work suggests that high dosage RUL ECT delivered with an ultrabrief stimulus maintains efficacy and results in minimal retrograde amnesia even in the period immediately following the ECT course (Sackeim, 2004b).…”

Section: Discussionmentioning

confidence: 99%

“…Anterograde learning and memory were assessed with the Complex Figure Test (CFT) (Rey, 1941;Spreen and Strauss, 1998) and the Buschke Selective Reminding Test (BSRT) (Buschke, 1973;Hannay and Levin, 1985). Deficits in delayed recall on the BSRT have been repeatedly documented shortly following ECT, and found to be sensitive to variation in the treatment technique (Sackeim et al, 1993;Sackeim et al, 2000). Retrograde amnesia for autobiographical information was measured with the Columbia University Autobiographical Memory Interview-Short Form (AMI-SF) (McElhiney et al, 1997.…”

Section: Study Measuresmentioning

confidence: 99%

“…Retrograde amnesia for autobiographical information was measured with the Columbia University Autobiographical Memory Interview-Short Form (AMI-SF) (McElhiney et al, 1997. The original version of the AMI, containing 281 items, has shown strong reliability and validity as a measure of retrograde amnesia, and sensitivity to variation in ECT technique McElhiney et al, 1995;Sackeim et al, 1993Sackeim et al, , 2000Sobin et al, 1995). Three alternate versions of the mMMS, CFT, and BSRT were randomized to testing occasion.…”

Section: Study Measuresmentioning

confidence: 99%

“…Randomized-controlled trials have shown more severe short-term memory deficits with sine wave compared to brief pulse stimulation (Valentine et al, 1968;Weiner et al, 1986), bilateral (BL) compared to right unilateral (RUL) electrode placement (Lancaster et al, 1958;Sackeim et al, 1986;Sackeim et al, 1993;Sackeim et al, 2000), and higher electrical dosage (McCall et al, 2000;Ottosson, 1960;Sackeim et al, 1993). These adverse effects are reduced by the use of RUL ECT with brief or ultrabrief pulse stimulation and electrical dosage titrated to the needs of the individual patient (Sackeim, 2004b).…”

Section: Introductionmentioning

confidence: 99%

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The Cognitive Effects of Electroconvulsive Therapy in Community Settings

Sackeïm

Prudic

Fuller

et al. 2006

Neuropsychopharmacol

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370

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Despite ongoing controversy, there has never been a large-scale, prospective study of the cognitive effects of electroconvulsive therapy (ECT). We conducted a prospective, naturalistic, longitudinal study of clinical and cognitive outcomes in patients with major depression treated at seven facilities in the New York City metropolitan area. Of 751 patients referred for ECT with a provisional diagnosis of a depressive disorder, 347 patients were eligible and participated in at least one post-ECT outcome evaluation. The primary outcome measures, Modified Mini-Mental State exam scores, delayed recall scores from the Buschke Selective Reminding Test, and retrograde amnesia scores from the Columbia University Autobiographical Memory Interview-SF (AMI-SF), were evaluated shortly following the ECT course and 6 months later. A substantial number of secondary cognitive measures were also administered. The seven sites differed significantly in cognitive outcomes both immediately and 6 months following ECT, even when controlling for patient characteristics. Electrical waveform and electrode placement had marked cognitive effects. Sine wave stimulation resulted in pronounced slowing of reaction time, both immediately and 6 months following ECT. Bilateral (BL) ECT resulted in more severe and persisting retrograde amnesia than right unilateral ECT. Advancing age, lower premorbid intellectual function, and female gender were associated with greater cognitive deficits. Thus, adverse cognitive effects were detected 6 months following the acute treatment course. Cognitive outcomes varied across treatment facilities and differences in ECT technique largely accounted for these differences. Sine wave stimulation and BL electrode placement resulted in more severe and persistent deficits.

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Section: Discussionmentioning

confidence: 99%

Section: Study Measuresmentioning

confidence: 99%

Section: Study Measuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Cognitive Effects of Electroconvulsive Therapy in Community Settings

Sackeïm

Prudic

Fuller

et al. 2006

Neuropsychopharmacol

Self Cite

488

370

View full text Add to dashboard Cite

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“…This patient group had not responded adequately to 2-6 trials of known effective treatments delivered at adequate doses and durations in the current MDE as assessed by the Antidepressant Treatment History Form (Oquendo et al, 1999;Prudic et al, 1996;Prudic et al, 1990;Sackeim et al, 1990;Sackeim et al, 2000;Sackeim, 2001). When counting all clinical treatments received, patients had on average received over 12 different medications in the current MDE.…”

Section: Methodsmentioning

confidence: 99%

The Montgomery Äsberg and the Hamilton ratings of depression: A comparison of measures

Carmody

Rush

Bernstein

et al. 2006

European Neuropsychopharmacology

200

132

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The 17-item Hamilton Rating Scale for Depression (HRSD 17 ) and the Montgomery Äsberg Depression Rating Scale (MADRS) are two widely used clinicianrated symptom scales. A 6-item version of the HRSD (HRSD 6 ) was created by Bech to address the psychometric limitations of the HRSD 17 . The psychometric properties of these measures were compared using classical test theory (CTT) and item response theory (IRT) methods. IRT methods were used to equate total scores on any two scales. Data from two distinctly different outpatient studies of nonpsychotic major depression: a 12-month study of highly treatment-resistant patients (n=233) and an 8-week acute phase drug treatment trial (n=985) were used for robustness of results.MADRS and HRSD 6 items generally contributed more to the measurement of depression than HRSD 17 items as shown by higher item-total correlations and higher IRT slope parameters. The MADRS and HRSD 6 were unifactorial while the HRSD 17 contained 2 factors. The MADRS showed about twice the precision in estimating depression as either the HRSD 17 or HRSD 6 for average severity of depression. An HRSD 17 of 7 corresponded to an 8 or 9 on the MADRS and 4 on the HRSD 6 .The MADRS would be superior to the HRSD 17 in the conduct of clinical trials.

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