Efficacy and memory problems following electroconvulsive therapy

The most important adverse effect of ECT is the occurrence of retrograde amnesia. This is a major obstacle for the more widespread use of the most efficacious treatment of depression.

Studies suggest that clinicians can manipulate the efficacy and amnesic effects of ECT to a certain degree by using different ECT techniques. In general the most efficacious forms of ECT also show more serious amnesic effects. A comparison of several ECT techniques is useful to confirm the findings from previous studies in different clinical settings.

In this study patients are randomised in two groups. In group one patients receive treatment with unilateral, ultra-briefpulse (=pulsewidth 0.3 msec) ECT, in group two patients receive treatment with unilateral, briefpulse (=pulsewidth 1 msec) ECT. The antidepressive action is assessed using depression rating scales and adverse cognitive effects are assessed using a neuropsychological test battery. Assessments are done single-blind.

Ultra-briefpulse (=pulsewidth 0.3 msec) ECT is equally efficacious as briefpulse (=pulsewidth 1 msec) ECT in its antidepressive action but causes less retrograde amnesia.

Depression score: baseline, weekly for six weeks, end point after six weeks

Memory score: baseline, three weeks, end point after six weeks

Ultra-briefpulse ECT (=pulsewidth 0.3 msec) vs. briefpulse ECT (=pulsewidth 1 msec)