Influence of resistance to antidepressant pharmacotherapy on short-term response to electroconvulsive therapy

Pluijms, Esther M.; Birkenhäger, Tom K.; Huijbrechts, Irma; Moleman, P.

doi:10.1016/s0165-0327(00)00378-5

Cited by 32 publications

(15 citation statements)

References 9 publications

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“…5 In the current review, the primary outcome criterion was the remission rate. Remission is defined as either a score 7 or less on the 17-item HAM-D, a score of 10 or less on the 24-item HAM-D, or a score of 8 or less on the Montgomery-Asberg Depression Rating Scale, with preference given in that order if more than 1 scale was reported.…”

Section: Clinical Outcomesmentioning

confidence: 99%

Antidepressant Pharmacotherapy Failure and Response to Subsequent Electroconvulsive Therapy

Heijnen

Birkenhäger

Wierdsma

et al. 2010

Journal of Clinical Psychopharmacology

196

106

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Failure to respond to antidepressants probably is the most common indication for electroconvulsive therapy (ECT). The literature seems to be divided as to whether medication resistance has a negative influence on the efficacy of subsequent ECT. Therefore, we performed a systematic review to investigate the effect of previous pharmacotherapy failure on the efficacy of ECT. Relevant cohort studies were identified from systematic search of the PubMed electronic database. Seven studies were included in this meta-analysis: the overall remission rate amounts to 48.0% (281/585) for patients with and 64.9% (242/373) for patients without previous pharmacotherapy failure. An exact analysis with the Mantel-Haenszel method (fixed effect model) shows a reduced efficacy of ECT in patients that received previous pharmacotherapy (OR, 0.52; 95% confidence interval [CI], 0.39-0.69). In conclusion, the efficacy of ECT is significantly superior in patients without previous pharmacotherapy failure as compared with medication-resistant patients. Because this finding is based on observational studies, it might be caused by a confounding factor, for example, the presence of psychotic features or the duration of the index episode. Electroconvulsive therapy seems to be an effective treatment for severely depressed patients as well as for patients with previous pharmacotherapy failure.

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Section: Clinical Outcomesmentioning

confidence: 99%

Antidepressant Pharmacotherapy Failure and Response to Subsequent Electroconvulsive Therapy

Heijnen

Birkenhäger

Wierdsma

et al. 2010

Journal of Clinical Psychopharmacology

196

106

View full text Add to dashboard Cite

show abstract

“…9 It is encouraging that even in severely depressed inpatients who have failed multiple antidepressant medication trials, ECT can be effective.…”

Section: Discussionmentioning

confidence: 99%

“…The influence of medication resistance on response to ECT has been investigated in The Netherlands in 2 retrospective studies with a relatively small sample size. 8,9 Both studies found no influence of medication resistance on the outcome of subsequent ECT.…”

mentioning

confidence: 98%

Effect of Antidepressant Medication Resistance on Short-term Response to Electroconvulsive Therapy

Broek

Lely²,

Mulder³

et al. 2004

Journal of Clinical Psychopharmacology

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This prospective study assessed the influence of resistance to antidepressant pharmacotherapy on the short-term response to subsequent electroconvulsive therapy (ECT). Previous research has shown that patients with medication resistance were less likely to respond to ECT. This finding may be applicable to the population of depressed inpatients in The Netherlands, where ECT is often preceded by several medication trials. Eighty-five patients (61 female and 24 male patients) with DSM-IV criteria for depressive disorder, both with and without mood congruent psychotic features, were included for analysis. Medication resistance was rated with the Antidepressant Treatment History Form. Medication resistance was predefined in accordance with the previous research in this field. When a reduction of at least 50% on the 17-item version of the Hamilton Rating Scale for Depression (HRSD) between pre- and post-ECT is used as response criterion, medication-resistant patients were equally likely to respond to subsequent ECT (30/48 = 82.5%) than patients without medication resistance (30/37 = 81.1%). Even when post-ECT HRSD score < or = 7 was used (full remission), there was no significant difference between medication-resistant patients (21/48 = 43.8%) and patients without medication resistance (15/37 = 40.5%). When potential confounding variables were taken into account, these differences remain nonsignificant. In contrast to earlier research, medication resistance does not influence short-term response to subsequent ECT and it can still be of considerable efficacy.

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“…Two studies that examined degree of medication resistance found a significant association with ECT response in the expected direction, 2,3 2 studies found nonsignificant associations in the expected direction, 4,5 and 1 study found no significant association and no obvious trend. 6 Thus, we are confident that lack of an adequate medication trial in the current episode predicts a greater likelihood of ECT response. Greater degree of medication resistance may also predict a lesser likelihood of ECT response, but future work will be needed to rigorously test this idea.…”

Section: Drs Haq and Mickey Replymentioning

confidence: 95%

Who Gets ECT Without Failing Medication First?

DeQuardo¹

2016

J. Clin. Psychiatry

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Influence of resistance to antidepressant pharmacotherapy on short-term response to electroconvulsive therapy

Cited by 32 publications

References 9 publications

Antidepressant Pharmacotherapy Failure and Response to Subsequent Electroconvulsive Therapy

Antidepressant Pharmacotherapy Failure and Response to Subsequent Electroconvulsive Therapy

Effect of Antidepressant Medication Resistance on Short-term Response to Electroconvulsive Therapy

Who Gets ECT Without Failing Medication First?

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