Efficacy of electroconvulsive therapy as a potential first‑choice treatment in treatment‑resistant depression (Review)

Abstract

Electroconvulsive therapy (ECT) is a technique that has been used since 1938 to treat several psychiatric disorders as a replacement for chemically induced seizures. Despite its history of stigma, controversy and low accessibility, ECT is found to be beneficial and efficient in severe cases of depression where medication fails to bring results. Titration tables developed over time, based on evidenced-based medicine, have made this treatment technique safe and, in some cases, the first choice of treatment. The aim of the review was to summarize the research conducted on the efficacy of ECT on major depressive disorder and variables studied such as technique, comorbidities and medication as well as the effects and outcomes of this procedure. At the same time, the application and correlations with other psychiatric and neurological disorders, including catatonia, agitation and aggression in individuals with dementia, schizophrenia, and epilepsy were assessed. There are no statistically demonstrated effects due to the fact that a small number of moderate-quality studies have been published; however, the combination of ECT technique with standard medication and care, can improve patient outcome. Furthermore, with regard to ECT, widespread and robust volume changes in both cortical and subcortical regions have been shown. Antidepressant response and volumetric increases appear to be limited by the specific neuroplasticity threshold of each patient.

Cerebro-cerebellar functional neuroplasticity mediates the effect of electric field on electroconvulsive therapy outcomes

“…MDD is characterized by persistently depressed mood, anhedonia, impaired cognitive function, and suicidal thoughts [2]. Electroconvulsive therapy (ECT) is one of the most effective treatments along with accelerated transcranial magnetic stimulation, repetitive transcranial magnetic stimulation, Ketamine, and deep brain stimulation for treatment-resistant depressive episodes, which passes a controlled electric current through the brain under general anesthesia, producing substantial improvement in 60 to 80 percent of patients [3]. Despite its effectiveness, ECT may cause cognitive side-effects, including impairment in attention, memory, and executive functioning [4][5][6].…”

Perception and Facts Regarding Electroconvulsive Therapy at Benazir Bhutto Hospital, Rawalpindi

“…6 Previous research indicates that a combination of ECT and the maintenance medication is highly effective as compared to medication alone. 8,9 Mechanism of ECT Electroconvulsive Therapy has been considered as an effective treatment for certain psychiatric disorders as evidenced by extensive research. 10,11 Ladislas Meduna is recognized as the inventor of ECT.…”

Risk-to-befit ratios of consecutive antidepressants for heavy menstrual bleeding in young women with bipolar disorder or major depressive disorder

“…Serious mood disorders such as bipolar disorder (BP) and major depressive disorder (MDD) ( 1 ) have high prevalence among young women (aged 18–35 years) ( 2 – 9 ). Typically, these disorders are treated using mood stabilizers [not a true pharmacological category ( 10 )] and antidepressants ( 11 – 17 ). However, these treatments could result in adverse secondary effects ( 18 , 19 ), including menstrual dysfunction ( 20 – 30 ) (e.g., hypomenorrhea/amenorrhea) and heavy menstrual bleeding (HMB) ( 31 ).…”