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Clinical efficacy and cognitive side effects of bifrontal versus right unilateral electroconvulsive therapy (ECT): a short-term randomised controlled trial in pharmaco-resistant major depression.
J Affect Disord. 2007 Aug; 101(1-3):149-57.JA

Abstract

BACKGROUND

In most studies right unilateral electroconvulsive therapy (ECT) has been shown to cause fewer cognitive side effects but less antidepressant efficacy compared with bi(fronto)temporal ECT at certain intensities.

AIMS

To compare the short-term efficacy and side effects of right unilateral ECT and bifrontal ECT.

METHODS

In a double-blind randomised controlled clinical trial, 92 patients diagnosed with pharmaco-resistant major depression received either six right unilateral ECT treatments (250% stimulus intensity of titrated threshold) or six bifrontal ECT (150% of threshold) treatments over a 3-week period. Concomitant psychotropic medications were continued during ECT treatments. The severity of depression and cognitive status was assessed prior to the first ECT and one day after the sixth ECT using the 21-item Hamilton Depression Rating Scale and the modified Mini Mental State Examination.

RESULTS

Eight patients did not complete the course of the study due to minor side effects or withdrawal of consent. The mean Hamilton Depression score decreased from 27 to 17 points in both groups of 46 patients, resulting in 12 responders (primary endpoint defined as a decrease >50%) in each patient group (95% confidence interval for the odds ratio from 0.35 to 2.8). There was no reduction in the modified Mini Mental State score (mean score 86 of 100 points).

CONCLUSIONS

Both bifrontal and right unilateral electrode placements in ECT were reasonably safe and moderately efficacious in reducing symptoms of pharmaco-resistant major depression.

Authors+Show Affiliations

Department of Psychiatry and Psychotherapy, Eberhard-Karls University Tuebingen, Germany. gerhard.eschweiler@med.uni-tuebingen.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17196664

Citation

Eschweiler, Gerhard W., et al. "Clinical Efficacy and Cognitive Side Effects of Bifrontal Versus Right Unilateral Electroconvulsive Therapy (ECT): a Short-term Randomised Controlled Trial in Pharmaco-resistant Major Depression." Journal of Affective Disorders, vol. 101, no. 1-3, 2007, pp. 149-57.
Eschweiler GW, Vonthein R, Bode R, et al. Clinical efficacy and cognitive side effects of bifrontal versus right unilateral electroconvulsive therapy (ECT): a short-term randomised controlled trial in pharmaco-resistant major depression. J Affect Disord. 2007;101(1-3):149-57.
Eschweiler, G. W., Vonthein, R., Bode, R., Huell, M., Conca, A., Peters, O., Mende-Lechler, S., Peters, J., Klecha, D., Prapotnik, M., DiPauli, J., Wild, B., Plewnia, C., Bartels, M., & Schlotter, W. (2007). Clinical efficacy and cognitive side effects of bifrontal versus right unilateral electroconvulsive therapy (ECT): a short-term randomised controlled trial in pharmaco-resistant major depression. Journal of Affective Disorders, 101(1-3), 149-57.
Eschweiler GW, et al. Clinical Efficacy and Cognitive Side Effects of Bifrontal Versus Right Unilateral Electroconvulsive Therapy (ECT): a Short-term Randomised Controlled Trial in Pharmaco-resistant Major Depression. J Affect Disord. 2007;101(1-3):149-57. PubMed PMID: 17196664.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical efficacy and cognitive side effects of bifrontal versus right unilateral electroconvulsive therapy (ECT): a short-term randomised controlled trial in pharmaco-resistant major depression. AU - Eschweiler,Gerhard W, AU - Vonthein,Reinhard, AU - Bode,Ruediger, AU - Huell,Michael, AU - Conca,Andreas, AU - Peters,Oliver, AU - Mende-Lechler,Stefan, AU - Peters,Julia, AU - Klecha,Dorothee, AU - Prapotnik,Michael, AU - DiPauli,Jan, AU - Wild,Barbara, AU - Plewnia,Christian, AU - Bartels,Mathias, AU - Schlotter,Wilfried, Y1 - 2006/12/28/ PY - 2006/08/26/received PY - 2006/11/10/revised PY - 2006/11/13/accepted PY - 2007/1/2/pubmed PY - 2007/8/19/medline PY - 2007/1/2/entrez SP - 149 EP - 57 JF - Journal of affective disorders JO - J Affect Disord VL - 101 IS - 1-3 N2 - BACKGROUND: In most studies right unilateral electroconvulsive therapy (ECT) has been shown to cause fewer cognitive side effects but less antidepressant efficacy compared with bi(fronto)temporal ECT at certain intensities. AIMS: To compare the short-term efficacy and side effects of right unilateral ECT and bifrontal ECT. METHODS: In a double-blind randomised controlled clinical trial, 92 patients diagnosed with pharmaco-resistant major depression received either six right unilateral ECT treatments (250% stimulus intensity of titrated threshold) or six bifrontal ECT (150% of threshold) treatments over a 3-week period. Concomitant psychotropic medications were continued during ECT treatments. The severity of depression and cognitive status was assessed prior to the first ECT and one day after the sixth ECT using the 21-item Hamilton Depression Rating Scale and the modified Mini Mental State Examination. RESULTS: Eight patients did not complete the course of the study due to minor side effects or withdrawal of consent. The mean Hamilton Depression score decreased from 27 to 17 points in both groups of 46 patients, resulting in 12 responders (primary endpoint defined as a decrease >50%) in each patient group (95% confidence interval for the odds ratio from 0.35 to 2.8). There was no reduction in the modified Mini Mental State score (mean score 86 of 100 points). CONCLUSIONS: Both bifrontal and right unilateral electrode placements in ECT were reasonably safe and moderately efficacious in reducing symptoms of pharmaco-resistant major depression. SN - 0165-0327 UR - https://www.unboundmedicine.com/medline/citation/17196664/Clinical_efficacy_and_cognitive_side_effects_of_bifrontal_versus_right_unilateral_electroconvulsive_therapy__ECT_:_a_short_term_randomised_controlled_trial_in_pharmaco_resistant_major_depression_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(06)00490-3 DB - PRIME DP - Unbound Medicine ER -