- 作者：Gerhard W. Eschweiler ; Reinhard Vonthein ; Ruediger Bode ; Michael Huell ; Andreas Conca ; Oliver Peters ; Stefan Mende-Lechler ; Julia Peters ; Dorothee Klecha ; Michael Prapotnik ; et al.
- 关键词：Major depression ; Electroconvulsive therapy ; Electrode position ; Neuropsychology ; Randomised clinical trial
- 刊名：Journal of Affective Disorders
- 出版年：2007
- 出版时间：August 2007
- 年：2007
- 卷：101
- 期：1-3
- 页码：149-157
- 全文大小：304 K
In most studies right unilateral electroconvulsive therapy (ECT) has been shown to cause fewer cognitive side effects but less antidepressant efficacy compared with bi(fronto)temporal ECT at certain intensities.
Aims
To compare the short-term efficacy and side effects of right unilateral ECT and bifrontal ECT.
Methods
In a double-blind randomised controlled clinical trial, 92 patients diagnosed with pharmaco-resistant major depression received either six right unilateral ECT treatments (250 % stimulus intensity of titrated threshold) or six bifrontal ECT (150 % of threshold) treatments over a 3-week period. Concomitant psychotropic medications were continued during ECT treatments. The severity of depression and cognitive status was assessed prior to the first ECT and one day after the sixth ECT using the 21-item Hamilton Depression Rating Scale and the modified Mini Mental State Examination.
Results
Eight patients did not complete the course of the study due to minor side effects or withdrawal of consent. The mean Hamilton Depression score decreased from 27 to 17 points in both groups of 46 patients, resulting in 12 responders (primary endpoint defined as a decrease > 50 % ) in each patient group (95 % confidence interval for the odds ratio from 0.35 to 2.8). There was no reduction in the modified Mini Mental State score (mean score 86 of 100 points).
Conclusions
Both bifrontal and right unilateral electrode placements in ECT were reasonably safe and moderately efficacious in reducing symptoms of pharmaco-resistant major depression.