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Randomized Controlled Trial
. 2014 Dec 5;18(1):pyu045.
doi: 10.1093/ijnp/pyu045.

A randomized controlled trial of brief and ultrabrief pulse right unilateral electroconvulsive therapy

Colleen K Loo  1 , Natalie Katalinic  2 , Deirdre J Smith  2 , Anna Ingram  2 , Nathan Dowling  2 , Donel Martin  2 , Kerryn Addison  2 , Dusan Hadzi-Pavlovic  2 , Brett Simpson  2 , Isaac Schweitzer  2
Affiliations
Randomized Controlled Trial

A randomized controlled trial of brief and ultrabrief pulse right unilateral electroconvulsive therapy

Colleen K Loo et al. Int J Neuropsychopharmacol. .

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] Int J Neuropsychopharmacol. 2016 Apr 27;19(10):pyw031. doi: 10.1093/ijnp/pyw031. Int J Neuropsychopharmacol. 2016. PMID: 27207904 Free PMC article. No abstract available.

Abstract

Background: Some studies suggest better overall outcomes when right unilateral electroconvulsive therapy (RUL ECT) is given with an ultrabrief, rather than brief, pulse width.

Methods: The aim of the study was to test if ultrabrief-pulse RUL ECT results in less cognitive side effects than brief- pulse RUL ECT, when given at doses which achieve comparable efficacy. One hundred and two participants were assigned to receive ultrabrief (at 8 times seizure threshold) or brief (at 5 times seizure threshold) pulse RUL ECT in a double-blind, randomized controlled trial. Blinded raters assessed mood and cognitive functioning over the ECT course.

Results: Efficacy outcomes were not found to be significantly different. The ultrabrief group showed less cognitive impairment immediately after a single session of ECT, and over the treatment course (autobiographical memory, orientation).

Conclusions: In summary, when ultrabrief RUL ECT was given at a higher dosage than brief RUL ECT (8 versus 5 times seizure threshold), efficacy was comparable while cognitive impairment was less.

Trial registration: ClinicalTrials.gov NCT00870805.

Keywords: cognitive; depression; electroconvulsive therapy; pulse width; randomized controlled trial.

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Figures

Figure 1.
Figure 1.
CONSORT diagram.
Figure 2.
Figure 2.
(A) Mean Montgomery-Åsberg Depression Rating Scale (MADRS) scores at baseline, week 1, week 2, and after the final ECT, adjusted for covariates; (B) Mean MADRS scores at 1 week, 1 month, and 6 month follow-ups, adjusted for covariates.
See this image and copyright information in PMC

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