Drug therapy response doesn't predict ECT response

NEW YORK (Reuters Health) - Despite some research findings that suggest depressed patients who don't respond to treatment with antidepressant drugs have poor rate of remission with electroconvulsive therapy (ECT), this appears not to be the case, according to a report in the Journal of Clinical Psychiatry.

"The implication of our study," lead investigator Dr. Keith G. Rasmussen told Reuters Health, "is that even if a depressed patient has not responded to one or more antidepressant medication trials, ECT still has...success rates as high as patients who have not had a medication trial before ECT."

ECT, used to treat severe depression, is performed under very strict guidelines by trained professionals supervised by a psychiatrist. The patient's brain is stimulated with a brief controlled series of electrical pulses that cause a brain seizure that lasts for about 1 minute. Prior to ECT, the patient is given general anesthesia and a muscle relaxant to prevent pain and convulsions.

Dr. Rasmussen of the Mayo Clinic College of Medicine, Rochester, Minnesota and colleagues studied 345 non-psychotic depressed patients scheduled for ECT.

The subjects completed a medication history form and were assessed with the 24-item Hamilton Rating Scale for Depression both before and after ECT. Complete medication data were available for 216 patients and the average number of previous drug trials in this group ranged from 0 to 6 per patient.

The researchers found no significant association between the patients' response to antidepressant drugs and their response to ECT - the failure of drug treatment did not predict a poor response to ECT.

For patients who meet the treatment criteria, "antidepressant medication resistance should not sway the clinician from providing (ECT)."

SOURCE: Journal of Clinical Psychiatry, November 2007.

.