The influence of concomitant antidepressant medication on safety, tolerability and clinical effectiveness of electroconvulsive therapy

Baghai, Thomas C.; Marcuse, A.; Brosch, Melanie; Schüle, Cornelius; Eser, Daniela; Steng, Yvonne; Noack, Ines; Pietschmann, Katrin; Möller, Hans‐Jürgen; Rupprecht, Rainer

doi:10.1080/15622970500213871

Cited by 62 publications

(29 citation statements)

References 33 publications

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“…In this respect, it has to be noted that the present results were not corrected for potentially confounding influences of further polymorphisms within the dopaminergic system previously found to be associated with ECT response, such as COMT Val 158 Met or DRD2 C957T Domschke et al 2009 ;Huuhka et al 2008), BDNF gene variation (Fernandes et al 2009 ;Huuhka et al 2007) or polymorphisms impacting ventral striatum responsiveness to emotional stimuli such as DAT 40-bp 3kVNTR or CNR1 rs1049353 (Chakrabarti et al 2006 ;Domschke et al 2008 ;Hahn et al 2011). Additionally, since 71.2 % of the present investigated patients concomitantly received antidepressant pharmacotherapy, 79.8 % adjunct neuroleptic medication and 20.2 % anxiolytic agents as invariably done in daily clinical practice, the present effect -although not statistically significant in our sample -could be influenced by concomitant antidepressant (Baghai et al 2006), antipsychotic -9 -7 -5 -3 -1 -9 -7 -5 -3 -1 (a) (b) Fig. 2.…”

Section: Discussionmentioning

confidence: 50%

Dopamine D3 receptor gene variation: impact on electroconvulsive therapy response and ventral striatum responsiveness in depression

Dannlowski

Domschke

Birosova

et al. 2013

International Journal of Neuropsychopharmacology

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Dysfunction of dopamine D₃ receptors, particularly in the mesocorticolimbic system, has been linked to the pathogenesis of major depression. Preclinical data show enhanced D₃ receptor binding in the striatum upon antidepressant medication and electroconvulsive therapy (ECT). Thus, the potential impact of dopamine D₃ receptor gene (DRD3) variation on ECT outcome in treatment-resistant major depression was evaluated by applying a combined molecular and imaging genetic approach. Altogether, 10 representative variants covering 95.4% of DRD3 gene variation were investigated for association with response to ECT in a sample of 104 (71 female, 33 male) Caucasian patients with pharmacorefractory major depression. Additionally, ventral striatum responsiveness to happy faces was assessed in two independent samples of depressed patients (total N=54) by means of functional magnetic resonance imaging at 3 T. Significant association of DRD3 rs3732790, rs3773679 and rs9817063 variants with response (uncorrected p=0.02-0.03) and remission (uncorrected p=0.01) after ECT was discerned. Logistic regression analyses revealed association of rs3732790 (uncorrected p=0.009; corrected p=0.045) and rs3773679 (uncorrected p=0.009; corrected p=0.045) with remission when applying a recessive model of inheritance. The rs3732790T allele conferring a more favourable treatment response was furthermore found to be associated with stronger striatal responsiveness to happy facial expressions (sample 1: cluster-corrected p=0.002; sample 2: p=0.023). In summary, the present study suggests some impact of DRD3 gene variation on ECT response, potentially mediated by alteration of striatal engagement during the processing of emotionally rewarding stimuli.

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Section: Discussionmentioning

confidence: 50%

Dopamine D3 receptor gene variation: impact on electroconvulsive therapy response and ventral striatum responsiveness in depression

Dannlowski

Domschke

Birosova

et al. 2013

International Journal of Neuropsychopharmacology

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“…Also, the present study does not allow for evaluation of a molecular pattern with a set of variations in a set of molecularly correlated enzymes related to COMT. Additionally, since 71.2% of the patients concomitantly received antidepressant pharmacotherapy as invariably done in daily clinical practice, the present effect-although not statistically significant in our sample-could be influenced by concomitant antidepressant pharmacotherapy [Baghai et al, 2006] and might therefore not be specific for ECT. Furthermore, the relatively small sample sizes of patients in the diagnostic subgroups (HAM-D sub-factors, gender) might have increased the risk for a false-negative or false-positive result.…”

Section: Cogenetics; Gendermentioning

confidence: 61%

COMT val158met influence on electroconvulsive therapy response in major depression

Domschke

Zavorotnyy

Diemer

et al. 2009

American J of Med Genetics Pt B

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There is strong evidence for a genetic contribution to the pathogenesis of depression, with the functional catechol-O-methyltransferase (COMT) val158met polymorphism having been suggested as a potential susceptibility factor. In the present study, the effect of COMT val158met on response to electroconvulsive therapy (ECT) was analyzed in a sample of 104 Caucasian patients (f = 71, m = 33) with pharmacologically treatment-resistant Major Depression. The higher active COMT 158val allele was found to be associated with (1) higher pre-ECT severity of depression and (2) better treatment response to ECT particularly regarding the core symptoms of depression as well as sleep-related symptoms. These findings were restricted to the female subgroup of patients. In summary, the present study supports a potentially gender-specific significant impact of COMT gene variation on electroconvulsive therapy response, with COMT 158val risk allele carriers suffering from more severe, pharmacologically less efficiently treatable depression and thus possibly deriving greater benefit from ECT in the first place.

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“…In general bilateral ECT is considered to be more effective than unilateral ECT and high-dosage ECT has been suggested to be more effective than low-dosage ECT (ECT Review Group 2003). Furthermore, several investigations suggested that concomitant psychopharmacological treatment administered during the course of ECT may alter the efficacy and safety of ECT (Baghai et al 2006;Nothdurfter et al 2006). In a first retrospective investigation we found that concomitant administration of mirtazapine and atypical antipsychotics enhanced the therapeutic effectiveness of ECT.…”

Section: Introductionmentioning

confidence: 83%

The influence of anaesthetic medication on safety, tolerability and clinical effectiveness of electroconvulsive therapy

Eser

Schüle

Damm

et al. 2010

The World Journal of Biological Psychiatry

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The influence of concomitant antidepressant medication on safety, tolerability and clinical effectiveness of electroconvulsive therapy

Cited by 62 publications

References 33 publications

Dopamine D3 receptor gene variation: impact on electroconvulsive therapy response and ventral striatum responsiveness in depression

Dopamine D3 receptor gene variation: impact on electroconvulsive therapy response and ventral striatum responsiveness in depression

COMT val158met influence on electroconvulsive therapy response in major depression

The influence of anaesthetic medication on safety, tolerability and clinical effectiveness of electroconvulsive therapy

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