Key updates in the clinical application of electroconvulsive therapy.

Published

Journal Article (Review)

ECT is the oldest and most effective therapy available for the treatment of severe major depression. It is highly effective in individuals with treatment resistance and when a rapid response is required. However, ECT is associated with memory impairment that is the most concerning side-effect of the treatment, substantially contributing to the controversy and stigmatization surrounding this highly effective treatment. There is overwhelming evidence for the efficacy and safety of an acute course of ECT for the treatment of a severe major depressive episode, as reflected by the recent FDA advisory panel recommendation to reclassify ECT devices from Class III to the lower risk category Class II. However, its application for other indications remains controversial, despite strong evidence to the contrary. This article reviews the indication of ECT for major depression, as well as for other conditions, including catatonia, mania, and acute episodes of schizophrenia. This study also reviews the growing evidence supporting the use of maintenance ECT to prevent relapse after an acute successful course of treatment. Although ECT is administered uncommonly to patients under the age of 18, the evidence supporting its use is also reviewed in this patient population. Finally, memory loss associated with ECT and efforts at more effectively monitoring and reducing it are reviewed.

Full Text

Duke Authors

Cited Authors

  • Weiner, RD; Reti, IM

Published Date

  • April 2017

Published In

Volume / Issue

  • 29 / 2

Start / End Page

  • 54 - 62

PubMed ID

  • 28406327

Pubmed Central ID

  • 28406327

Electronic International Standard Serial Number (EISSN)

  • 1369-1627

Digital Object Identifier (DOI)

  • 10.1080/09540261.2017.1309362

Language

  • eng

Conference Location

  • England