The efficacy and acceptability of hybrid electroconvulsive therapy compared with standard electroconvulsive therapy for schizophrenia patients: A parallel-group, double-blind, randomized, controlled trial

Improved Safety of Hybrid Electroconvulsive Therapy Compared With Standard Electroconvulsive Therapy in Patients With Major Depressive Disorder: A Randomized, Double-Blind, Parallel-Group Pilot Trial

“…Furthermore, other electrical treatments, such as rTMS and transcranial direct current stimulation, can also exert anti-depressive effects with fewer charge and side-effects ( 36 , 37 ). Furthermore, the ORT was significantly shorter in the HECT group, as reported in our previous HECT trial ( 14 ). A study of magnetic seizure therapy (MST) found that the recovery times for consciousness were shorter in the MST group than ECT ( 38 ).…”

“…In this trial, HECT showed similar anti-depressive effects to ECT but a significantly better safety profile. There were no significant differences in AE rates in phase 1 treatment between the two arms, but the HECT arm showed significantly fewer AEs in phase 2 than the ECT arm, similar to our previous HECT trial in schizophrenia ( 14 ). The LCE energy in the present trial was set to half of seizure threshold, approximately 1/3 of the energy used in ECT.…”

“…Subsequent treatments were administered at 1.5-times seizure threshold for ECT sessions and, for LCE sessions, the energy was set at half the seizure threshold, regardless of whether seizures were induced. Anesthesia included administration of etomidate (0.2–0.4 mg/kg), muscle relaxation with succinylcholine (1–2 mg/kg) and atropine (0–1 mg) depending on heart rate, and ventilation with 100% O 2 throughout the entire ECT or LCE procedures as described in our previous trial ( 14 ).…”

“…To test the efficacy and safety of HECT, we initiated two back-to-back preliminary randomized, double-blind, parallel-group, controlled clinical trials: one for schizophrenic patients and the other for MDD patients (reported here). The HECT RCT for schizophrenia completed several months earlier and demonstrated that, compared to ECT, HECT had similar antipsychotic effects but fewer AEs ( 14 ). Similarly, this trial tested the hypotheses that, compared to ECT (i) HECT exerts a similar antidepressant effect; and (ii) HECT causes fewer AEs and impairments in cognitive function, especially in the latter part of treatment (i.e., after three ECT sessions) and in the follow-up period.…”

Human in vivo evidence of reduced astrocyte activation and neuroinflammation in patients with treatment‐resistant depression following electroconvulsive therapy

“…In fact, in recent years, our team has been dedicated to the development of new ECT paradigms. Our proposed hybrid ECT [103][104][105] may hold the potential for addressing this issue, and relevant experiments are currently underway. We also encourage further research to address these limitations in order to enhance our understanding of the mechanisms involved in ECT and depression.…”