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Randomized Controlled Trial
. 2010 Jun;121(6):431-6.
doi: 10.1111/j.1600-0447.2009.01493.x. Epub 2009 Nov 8.

Electroconvulsive therapy is equally effective in unipolar and bipolar depression

S Bailine  1 , M Fink, R Knapp, G Petrides, M M Husain, K Rasmussen, S Sampson, M Mueller, S M McClintock, K G Tobias, C H Kellner
Affiliations
Randomized Controlled Trial

Electroconvulsive therapy is equally effective in unipolar and bipolar depression

S Bailine et al. Acta Psychiatr Scand. 2010 Jun.

Abstract

Objective: To determine the relative efficacy of electroconvulsive therapy (ECT) in the treatment of bipolar (BP) and unipolar (UP) depressive illness and clarify its role in BP depression.

Method: Patients referred for ECT with both UP and BP depressions. [classified by Structured Clinical Interview for DSM (SCID-I) criteria for history of mania] were included in a multi-site collaborative, double-masked, randomized controlled trial of three electrode placements - right unilateral, bifrontal or bitemporal - in a permutated block randomization scheme.

Results: Of 220 patients, 170 patients (77.3%) were classified as UP and 50 (22.7%) as BP depression in the intent-to-treat sample. The remission and response rates and numbers of ECT for both groups were equivalent.

Conclusion: Both UP and BP depressions remit with ECT. Polarity is not a factor in the response rate. In this sample ECT did not precipitate mania in depressed patients. Treatment algorithms for UP and BP depression warrant re-evaluation.

Trial registration: ClinicalTrials.gov NCT00069407.

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