Effects of Electroconvulsive Therapy on Depression and Its Potential Mechanism

Abstract

Depression is one of the most common disorders causing mortality around the world. Although electroconvulsive therapy (ECT) is, along with antidepressants and psychotherapy, one of the three major treatments of depression, it is still considered as the last resort for depressed patients. This situation is partially due to limited studies and uncertainty regarding its mechanism. However, decades of increased research have focused on the effects of ECT on depression and its potential mechanism. Furthermore, these investigations may suggest that ECT should be a first-line therapy for depression due to its profound effects in relieving desperation in certain situations. Here, we outline recent clinical and preclinical studies and summarize the advantages and disadvantages of ECT. Thus, this review may provide some hints for clinical application.

Keywords: ECT; Homer1a; cognition; depression; neuroplasticity.

FIGURE 1

The possible antidepressant mechanisms of ECS on depression. AMPA receptor, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor; mGlu1/5 receptor, metabotropic glutamate receptor 1/5; mTORC1, mammalian target of rapamycin complex 1; NMDAR, N-methyl-D-aspartate receptor; GABAAR, gamma-aminobutyric acid type A receptor; TrkB, tropomyosin receptor kinase B; Akt, protein kinase B; mTORC1, mammalian target of rapamycin complex 1; IP3R, inositol 1,4,5-trisphosphate receptor; BDNF, brain-derived neurotrophic factor.