Electroconvulsive Therapy (ECT) remains essential to contemporary psychiatric practice and is one of the safest and most effective treatments available for depression. Despite modern advances in pharmacotherapy, about 15-20 per cent of all hospitalised patients receive treatment with ECT. Its use, however, is limited by concerns over associated cognitive side effects. Recent research has suggested that using an ultrabrief pulsewidth with ECT may greatly reduce cognitive side effects, while maintaining efficacy (Sackeim et al 2008). Preliminary results were positive for unilateral ECT, however, suggest that for bilateral ECT, dosing may need to be adjusted to preserve efficacy while reducing side effects. This study will examine the relative cognitive side effects and efficacy of right unilateral and bilateral ECT given with a standard pulsewidth or an ultrabrief pulsewidth. Some participants will also receive an MRI scan before and after ECT.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
150
Bilateral ECT at 3-4 times seizure threshold with an ultrabrief pulse (0.3ms)
Bilateral ECT with at 1.5 times seizure threshold with a standard pulse (1.0ms)
Right-unilateral ECT at 6 times seizure threshold with an ultrabrief pulse (0.3ms)
Right-unilateral ECT with at 5 times seizure threshold with a standard pulse (1.0ms)
St George Hospital
Kogarah, New South Wales, Australia
Wandene Private Hospital
Kogarah, New South Wales, Australia
The Melbourne Clinic
Melbourne, Victoria, Australia
Change in scores on Memory Tests
Time frame: Before ECT, after 6 ECT treatments, after final ECT treatment, one month and six month follow-up
Change in scores on Depression Rating Scale
Time frame: Before ECT, after each week of treatment, at the end of the ECT course
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.