Relative Ineffectiveness of Ultrabrief Right Unilateral Versus Bilateral Electroconvulsive Therapy in Depression

McCormick, Laurie M.; Brumm, Michael C.; Benede, Ajith K.; Lewis, Jerry L.

doi:10.1097/yct.0b013e31819fdff7

Cited by 33 publications

(16 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This group has also noted diminished adverse cardiac effects with ultrabrief pulses (0.3–0.7 ms) compared to brief pulses (1 ms) 78. Some reports of the use of ultrabrief RUL ECT in hospital settings have supported its efficacy and reduced adverse sequelae,132 although McCormick et al have shown slower response and diminished efficacy with this paradigm compared to brief BL ECT 133. It should be noted that in the McCormick et al study the tabulated ultrabrief treatment dose was only 4 × seizure threshold, even though it was reported as 6 × seizure threshold, which could have resulted in reduced efficacy.…”

Section: Understanding the Ect Stimulus Parametersmentioning

confidence: 98%

Electroconvulsive Therapy Stimulus Parameters

Peterchev¹,

Rosa²,

Deng³

et al. 2010

The Journal of ECT

175

151

View full text Add to dashboard Cite

In this paper we review the parameters that define the ECT electrical stimulus and discuss their biophysical roles. We also present the summary metrics of charge and energy that are conventionally used to describe the dose of ECT and the rules commonly deployed to individualize the dose for each patient. We then highlight the limitations of these summary metrics and dosing rules in that they do not adequately capture the roles of the distinct stimulus parameters. Specifically, there is strong theoretical and empirical evidence that stimulus parameters (pulse amplitude, shape, and width, and train frequency, directionality, polarity, and duration) exert unique neurobiological effects that are important for understanding ECT outcomes. Consideration of the distinct stimulus parameters, in conjunction with electrode placement, is central to further optimization of ECT dosing paradigms to improve the risk/benefit ratio. Indeed, manipulation of specific parameters, such as reduction of pulse width and increase in number of pulses, has already resulted in dramatic reduction of adverse side effects, while maintaining efficacy. Furthermore, the manipulation of other parameters, such as current amplitude, which are commonly held at fixed, high values, might be productively examined as additional means of targeting and individualizing the stimulus, potentially reducing side effects. We recommend that ECT dose be defined using all stimulus parameters rather than a summary metric. All stimulus parameters should be noted in treatment records and published reports. To enable research on optimization of dosing paradigms, we suggest that ECT devices provide capabilities to adjust and display all stimulus parameters.

show abstract

Section: Understanding the Ect Stimulus Parametersmentioning

confidence: 98%

Electroconvulsive Therapy Stimulus Parameters

Peterchev¹,

Rosa²,

Deng³

et al. 2010

The Journal of ECT

175

151

View full text Add to dashboard Cite

show abstract

“…3 Ultrabrief (UB) ECT, a technique which uses a shorter pulse width (0.3-0.37 milliseconds) than the standard pulse width ECT treatments (0.5-2 milliseconds), has been gaining popularity due to its potentially improved cognitive adverse effect profile on short-term and autobiographical memory. 5 There is an ongoing debate about whether the risk/benefit ratio of this technique is superior, equal, or inferior to the standard ECT techniques currently being used. 5 There is an ongoing debate about whether the risk/benefit ratio of this technique is superior, equal, or inferior to the standard ECT techniques currently being used.…”

mentioning

confidence: 99%

Efficacy of Right Unilateral Ultrabrief Pulse Width ECT

et al. 2013

View full text Add to dashboard Cite

This UB ECT protocol demonstrated a similar response rate when compared to standard ECT protocols; however, an increase in the number of treatments was required. Ultrabrief protocols are a viable option for both bipolar and unipolar depression. In men, UB ECT protocols may be less advantageous due to a need to overcome a potentially higher seizure threshold in men; however, additional research is needed to confirm this finding.

show abstract

“…1 However, the evidence about its antidepressant effects is still doubted. 2 In this study, we tested the hypothesis that ultrabrief pulse right unilateral ECT (UBP-ECT) is as effective a treatment for depression as standard brief pulse right unilateral ECT (BP-ECT).…”

Section: Dear Editormentioning

confidence: 99%