Skip to main content Accessibility help
×
Home
Hostname: page-component-55597f9d44-jzjqj Total loading time: 0.247 Render date: 2022-08-14T02:00:04.636Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true } hasContentIssue true

Electroconvulsive therapy for depression: 80 years of progress

Published online by Cambridge University Press:  18 March 2021

George Kirov
Affiliation:
MRC Centre for Neuropsychiatric Genetics & Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
Sameer Jauhar
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Pascal Sienaert
Affiliation:
Academic Center for ECT and Neuromodulation, University Psychiatric Center, KU Leuven, Belgium
Charles H. Kellner
Affiliation:
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, South Carolina, USA
Declan M. McLoughlin*
Affiliation:
Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, St Patrick's University Hospital, Ireland
*
Correspondence: Declan M. McLoughlin. Email: d.mcloughlin@tcd.ie

Abstract

Electroconvulsive therapy is the most effective treatment for severe, psychotic or treatment-resistant depression. However, its effectiveness continues to be questioned, both in mainstream media and narratives within the scientific literature. In this analysis, we use an evidence-based approach to demonstrate the efficacy and safety of modern electroconvulsive therapy.

Type
Analysis
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Elias, A, Phutane, VH, Clarke, S, Prudic, J. Electroconvulsive therapy in the continuation and maintenance treatment of depression: systematic review and meta-analyses. Aust NZ J Psychiatry 2018; 52(5): 415–24.CrossRefGoogle ScholarPubMed
Sinclair, DJ, Zhao, S, Qi, F, Nyakyoma, K, Kwong, JS, Adams, CE. Electroconvulsive therapy for treatment-resistant schizophrenia. Cochrane Database Syst Rev 2019; 3(3): CD011847.Google ScholarPubMed
Leiknes, KA, Jarosh-von Schweder, L, Hoie, B. Contemporary use and practice of electroconvulsive therapy worldwide. Brain Behav 2012; 2(3): 283344.CrossRefGoogle ScholarPubMed
Buley, N, Copland, E, Hodge, S, Chaplin, R. A further decrease in the rates of administration of electroconvulsive therapy in England. J ECT 2017; 33(3): 198202.10.1097/YCT.0000000000000374CrossRefGoogle ScholarPubMed
Kolshus, E, Jelovac, A, McLoughlin, DM. Bitemporal versus high-dose right unilateral electroconvulsive therapy for depression: a systematic review and meta-analysis of randomised controlled trials. Psychol Med 2017; 47(3): 518–30.CrossRefGoogle Scholar
Husain, MM, Rush, AJ, Fink, M, Knapp, R, Petrides, G, Rummans, T, et al. Speed of response and remission in major depressive disorder with acute electroconvulsive therapy (ECT): a Consortium for Research in ECT (CORE) report. J Clin Psychiatry 2004; 65(4): 485–91.CrossRefGoogle Scholar
Ross, EL, Zivin, K, Maixner, DF. Cost-effectiveness of electroconvulsive therapy vs pharmacotherapy/psychotherapy for treatment-resistant depression in the United States. JAMA Psychiatry 2018; 75(7): 713–22.10.1001/jamapsychiatry.2018.0768CrossRefGoogle ScholarPubMed
UK ECT Review Group. Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet 2003; 361(9360): 799808.10.1016/S0140-6736(03)12705-5CrossRefGoogle Scholar
Tor, P-C, Bautovich, A, Wang, M-J, Martin, D, Harvey, SB, Loo, C. A systematic review and meta-analysis of brief vs ultrabrief right unilateral electroconvulsive therapy for depression. J Clin Psychiatry 2015; 76(9): e1092–8.10.4088/JCP.14r09145CrossRefGoogle Scholar
Abbott, CC, Quinn, D, Miller, J, Ye, E, Iqbal, S, Lloyd, M, et al. Electroconvulsive therapy pulse amplitude and clinical outcomes. Am J Geriatr Psychiatry 2021; 29(2): 166–78.10.1016/j.jagp.2020.06.008CrossRefGoogle ScholarPubMed
Dunne, R, McLoughlin, DM. Systematic review and meta-analysis of bifrontal electroconvulsive therapy versus bilateral and unilateral electroconvulsive therapy in depression. World J Biol Psychiatry 2012; 13: 248–58.CrossRefGoogle ScholarPubMed
Sahlem, GL, McCall, WV, Short, EB, Rosenquist, PB, Fox, JB, Youssef, NA, et al. A two-site, open-label, non-randomized trial comparing focal electrically-administered seizure therapy (FEAST) and right unilateral ultrabrief pulse electroconvulsive therapy (RUL-UBP ECT). Brain Stimul 2020; 13(5): 1416–25.CrossRefGoogle Scholar
Mutz, J, Vipulananthan, V, Carter, B, Hurlemann, R, Fu, CHY, Young, AH. Comparative efficacy and acceptability of non-surgical brain stimulation for the acute treatment of major depressive episodes in adults: systematic review and network meta-analysis. BMJ 2019; 364: l1079.CrossRefGoogle ScholarPubMed
Chen, JJ, Zhao, LB, Liu, YY, Fan, SH, Xie, P. Comparative efficacy and acceptability of electroconvulsive therapy versus repetitive transcranial magnetic stimulation for major depression: a systematic review and multiple-treatments meta-analysis. Behav Brain Res 2017; 320: 30–6.CrossRefGoogle ScholarPubMed
Kellner, CH, Knapp, R, Husain, MM, Rasmussen, K, Sampson, S, Cullum, M, et al. Bifrontal, bitemporal and right unilateral electrode placement in ECT: randomised trial. Br J Psychiatry 2010; 196(3): 226–34.CrossRefGoogle ScholarPubMed
Semkovska, M, Landau, S, Dunne, R, Kolshus, E, Kavanagh, A, Jelovac, A, et al. Bitemporal versus high-dose unilateral twice-weekly electroconvulsive therapy for depression (EFFECT-Dep): a pragmatic, randomized, non-inferiority trial. Am J Psychiatry 2016; 173(4): 408–17.CrossRefGoogle ScholarPubMed
Torring, N, Sanghani, SN, Petrides, G, Kellner, CH, Ostergaard, SD. The mortality rate of electroconvulsive therapy: a systematic review and pooled analysis. Acta Psychiatr Scand 2017; 135(5): 388–97.CrossRefGoogle ScholarPubMed
Jørgensen, MB, Rozing, MP, Kellner, CH, Osler, M. Electroconvulsive therapy, depression severity and mortality: data from the Danish National Patient Registry. J Psychopharmacol 2020; 34(3): 273–9.CrossRefGoogle ScholarPubMed
Osler, M, Rozing, MP, Christensen, GT, Andersen, PK, Jorgensen, MB. Electroconvulsive therapy and risk of dementia in patients with affective disorders: a cohort study. Lancet Psychiat 2018; 5(4): 348–56.CrossRefGoogle ScholarPubMed
Rozing, MP, Jorgensen, MB, Osler, M. Electroconvulsive therapy and later stroke in patients with affective disorders. Br J Psychiatry 2019; 214(3): 168170.CrossRefGoogle ScholarPubMed
Semkovska, M, McLoughlin, DM. Objective cognitive performance associated with electroconvulsive therapy for depression: a systematic review and meta-analysis. Biol Psychiatry 2010; 68(6): 568–77.CrossRefGoogle ScholarPubMed
Semkovska, M, McLoughlin, DM. Measuring retrograde autobiographical amnesia following electroconvulsive therapy: historical perspective and current issues. J ECT 2013; 29(2): 127–33.CrossRefGoogle ScholarPubMed
Brus, O, Nordanskog, P, Båve, U, Cao, Y, Hammar, Å, Landén, M, et al. Subjective memory immediately following electroconvulsive therapy. J ECT 2017; 33(2): 96103.CrossRefGoogle ScholarPubMed
van Diermen, L, van den Ameele, S, Kamperman, AM, Sabbe, BCG, Vermeulen, T, Schrijvers, D, et al. Prediction of electroconvulsive therapy response and remission in major depression: meta-analysis. Br J Psychiatry 2018; 212(2): 7180.CrossRefGoogle ScholarPubMed
Jelovac, A, Kolshus, E, McLoughlin, DM. Relapse following successful electroconvulsive therapy for major depression: a meta-analysis. Neuropsychopharmacology 2013; 38: 2467–74.CrossRefGoogle ScholarPubMed
Kellner, CH, Husain, MM, Knapp, RG, McCall, WV, Petrides, G, Rudorfer, MV, et al. A novel strategy for continuation ECT in geriatric depression: phase 2 of the PRIDE study. Am J Psychiatry 2016; 173(11): 1110–8.CrossRefGoogle ScholarPubMed
Bouckaert, F, Sienaert, P, Obbels, J, Dols, A, Vandenbulcke, M, Stek, M, et al. ECT: its brain enabling effects: a review of electroconvulsive therapy-induced structural brain plasticity. J ECT 2014; 30(2): 143–51.CrossRefGoogle ScholarPubMed
Ousdal, OT, Argyelan, M, Narr, KL, Abbott, C, Wade, B, Vandenbulcke, M, et al. Brain changes induced by electroconvulsive therapy are broadly distributed. Biol Psychiatry 2020; 87(5): 451–61.CrossRefGoogle ScholarPubMed
Soda, T, McLoughlin, DM, Clark, SR, Oltedal, L, Kessler, U, Haavik, J, et al. International consortium on the genetics of electroconvulsive therapy and severe depressive disorders (Gen-ECT-ic). Eur Arch Psychiatry Clin Neurosci 2020; 270(7): 921–32.CrossRefGoogle Scholar
Submit a response

eLetters

No eLetters have been published for this article.
5
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Electroconvulsive therapy for depression: 80 years of progress
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Electroconvulsive therapy for depression: 80 years of progress
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Electroconvulsive therapy for depression: 80 years of progress
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *