Electroconvulsive therapy is equally effective in unipolar and bipolar depression.


Journal Article

OBJECTIVE: To determine the relative efficacy of electroconvulsive therapy (ECT) in the treatment of bipolar (BP) and unipolar (UP) depressive illness and clarify its role in BP depression. METHOD: Patients referred for ECT with both UP and BP depressions. [classified by Structured Clinical Interview for DSM (SCID-I) criteria for history of mania] were included in a multi-site collaborative, double-masked, randomized controlled trial of three electrode placements - right unilateral, bifrontal or bitemporal - in a permutated block randomization scheme. RESULTS: Of 220 patients, 170 patients (77.3%) were classified as UP and 50 (22.7%) as BP depression in the intent-to-treat sample. The remission and response rates and numbers of ECT for both groups were equivalent. CONCLUSION: Both UP and BP depressions remit with ECT. Polarity is not a factor in the response rate. In this sample ECT did not precipitate mania in depressed patients. Treatment algorithms for UP and BP depression warrant re-evaluation.

Full Text

Duke Authors

Cited Authors

  • Bailine, S; Fink, M; Knapp, R; Petrides, G; Husain, MM; Rasmussen, K; Sampson, S; Mueller, M; McClintock, SM; Tobias, KG; Kellner, CH

Published Date

  • June 2010

Published In

Volume / Issue

  • 121 / 6

Start / End Page

  • 431 - 436

PubMed ID

  • 19895623

Pubmed Central ID

  • 19895623

Electronic International Standard Serial Number (EISSN)

  • 1600-0447

Digital Object Identifier (DOI)

  • 10.1111/j.1600-0447.2009.01493.x


  • eng

Conference Location

  • United States