Similar clinical improvement of depression using 0.5-ms and 1-ms pulse widths in bilateral electroconvulsive therapy
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ORIGINAL PAPER
Similar clinical improvement of depression using 0.5‑ms and 1‑ms pulse widths in bilateral electroconvulsive therapy Aida de Arriba‑Arnau1,2 · Virginia Soria1,2,3 · Neus Salvat‑Pujol1,2 · José M. Menchón1,2,3 · Mikel Urretavizcaya1,2,3 Received: 19 July 2019 / Accepted: 23 November 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract There is a lack of research regarding 0.5-ms pulse width (PW) in bilateral electroconvulsive therapy (ECT). The aim of this study was to compare the efficacy and number of treatment sessions between groups receiving 0.5-ms and 1-ms PW ECT. Ninety-four patients with unipolar major depression treated with acute bilateral ECT were analysed retrospectively, grouped as consecutive patients treated with 0.5-ms PW ECT (n = 47), and age- and sex-matched patients treated with 1-ms PW ECT. Clinical and ECT data were extracted from clinical records. Symptom evaluations and global cognitive screening at baseline and post-ECT were administered by trained psychiatrists. The Hamilton Rating Scale for Depression (HDRS-21) was rated weekly. Efficacy and number of treatment sessions were compared between groups. PW was explored as a predictor of mean decrease in HDRS and number of treatment sessions by regression models. Group characteristics did not differ at baseline. The mean decrease in HDRS in the 0.5- and 1-ms PW [25.85 (7.79) vs. 24.33 (6.99), respectively], response (95.7% vs. 97.9%), remission (87.2% vs. 80.9%) and mean number of treatment sessions [11.28 (3.85) vs. 11.34 (3.36)] were not significantly different. Episode duration and severity, and previous ECT predicted HDRS decrease. Severity at baseline and the 6th session, the dosing method and the last ECT treatment dose predicted the number of treatment sessions needed. PW was not significant in the regressions models. The results suggest that both PWs perform similarly in bilateral ECT for depression, resulting in equivalent antidepressant efficacy and number of treatment sessions needed. Keywords Unipolar depression · Major depression · Electroconvulsive therapy (ECT) · Pulse width · Brief pulse · Antidepressant
Introduction Electroconvulsive therapy (ECT) has a significant role in the treatment of psychiatric disorders [1–4]. It has especially high efficacy in major depression episodes showing a strong antidepressant effect [2, 4] and offering a significant improvement in health-related quality of life [5]. The ECT technique has improved notably as a result of modifications * Mikel Urretavizcaya [email protected] 1
Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) Neurosciences Group - Psychiatry and Mental Health, L’Hospitalet de Llobregat, Barcelona, Spain
2
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain
3
Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
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