Maintenance Electroconvulsive Therapy in Affective and Schizoaffective Disorder

Abstract

Twenty-one patients (13 depressives and 8 schizoaffectives) who underwent maintenance electroconvulsive therapy (M-ECT) were compared with controls who received maintenance pharmacotherapy alone. Measures of effectiveness and safety of maintenance treatment were prospectively obtained during a 1-year follow-up. Survival analysis demonstrated a significantly better outcome defined by time to rehospitalization for all patients of the M-ECT group. Regarding the subgroups, depressives of the M-ECT group had markedly decreased rehospitalization rates cmpared to depressive controls. Furthermore, M-ECT in depressives resulted in a significant reduction in hospitalization rates and duration during follow-up. In schizoaffective patients, a significant difference in survival time was found in favor of the M-ECT group. In both groups, schizoaffectives had a markedly poorer outcome compared to depressive subjects. Our results indicate that in selected patients M-ECT, at least in combination with supporting medication, may be an efficient and safe alternative to pharmacological continuation or maintenance therapy alone.

Rapid cycling bipolar disease: New concepts and treatments

“…Because many patients with rapid cycling are taking multiple medications, there is a greater potential for interactions with ECT. Maintenance ECT was as effective as lithium in preventing manic relapse and recurrence in a prospective study, as well as case series and case control studies, but rapid cycling was not explicitly studied [49,74,147].…”

Eficacia y patrón de uso de la terapia electroconvulsiva de continuación y mantenimiento en el trastorno depresivo mayor

“…Los 2 estudios naturalísticos restantes incluían un grupo de pacientes tratados con distintos psicofármacos, y en ellos la TEC-C/M se asociaba también a farmacoterapia 57,58 .…”

Electroconvulsive therapy as continuation and maintenance therapy in psychiatric disorders and Parkinson’s disease

“…Die wichtigste neuere Literatur über EKT zur Langzeitprophylaxe affektiver Störungen ist in Tabelle 2 zusammengefasst [18,21,[33][34][35][36][37][38][39][40][41][42][43]. Die Ergebnisse der einzelnen Studien zeigen deutlich, dass Patienten mit rezidivierenden affektiven Störungen, die in der Indexepisode auf Akut-EKT angesprochen haben, von einer Langzeitprophylaxe erheblich profitieren.…”

“…In einer nicht randomisierten, kontrollierten Followup Studie durch ein Jahr von Swoboda et al [43] wurden 13 depressive und 8 schizoaffektive Patienten, die M-EKT erhielten mit einer Kontrollgruppe verglichen, die nur eine medikamentöse Langzeittherapie erhielt. Eine Survivalanalyse der bis zur Rehospitalisierung vergangenen Zeit zeigte, dass die gesamte M-EKT Gruppe wesentlich besser abschnitt.…”