A Randomized Controlled Trial of Brief and Ultrabrief Pulse Right Unilateral Electroconvulsive Therapy

Background: Some studies suggest better overall outcomes when right unilateral electroconvulsive therapy (RUL ECT) is given with an ultrabrief, rather than brief, pulse width. Methods: The aim of the study was to test if ultrabrief-pulse RUL ECT results in less cognitive side effects than brief- pul...

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Bibliographic Details
Published in:	The international journal of neuropsychopharmacology 2015-01, Vol.18 (1), p.1-8
Main Authors:	Loo, Colleen K, Katalinic, Natalie, Smith, Deirdre J, Ingram, Anna, Dowling, Nathan, Martin, Donel, Addison, Kerryn, Hadzi-Pavlovic, Dusan, Simpson, Brett, Schweitzer, Isaac
Format:	Article
Language:	eng
Subjects:	Affect Cognition Disorders - etiology Depressive Disorder - therapy Double-Blind Method Electroconvulsive Therapy - adverse effects Electroconvulsive Therapy - methods Female Humans Male Middle Aged Neuropsychological Tests Psychiatric Status Rating Scales Seizures - etiology Treatment Outcome
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Summary:	Background: Some studies suggest better overall outcomes when right unilateral electroconvulsive therapy (RUL ECT) is given with an ultrabrief, rather than brief, pulse width. Methods: The aim of the study was to test if ultrabrief-pulse RUL ECT results in less cognitive side effects than brief- pulse RUL ECT, when given at doses which achieve comparable efficacy. One hundred and two participants were assigned to receive ultrabrief (at 8 times seizure threshold) or brief (at 5 times seizure threshold) pulse RUL ECT in a double-blind, randomized controlled trial. Blinded raters assessed mood and cognitive functioning over the ECT course. Results: Efficacy outcomes were not found to be significantly different. The ultrabrief group showed less cognitive impairment immediately after a single session of ECT, and over the treatment course (autobiographical memory, orientation). Conclusions: In summary, when ultrabrief RUL ECT was given at a higher dosage than brief RUL ECT (8 versus 5 times seizure threshold), efficacy was comparable while cognitive impairment was less.
ISSN:	1461-1457 1469-5111