Effects of stimulus intensity and electrode placement on the efficacy and cognitive effects of electroconvulsive therapy

Abstract: BACKGROUND. The efficacy of electroconvulsive therapy in major depression is established, but the importance of the electrical dosage and electrode placement in relation to efficacy and side effects is uncertain. METHODS. In a double-blind study, we randomly assigned 96 depressed patients to receive right unilateral or bilateral electroconvulsive therapy at either a low electrical dose (just above the seizure threshold) or a high dose (2.5 times the threshold). Symptoms of depression and cognitive functioning were assessed before, during, immediately after, and two months after therapy. Patients who responded to treatment were followed for one year to assess the rate of relapse. RESULTS. The response rate for low-dose unilateral electroconvulsive therapy was 17 percent, as compared with 43 percent for high-dose unilateral therapy (P = 0.054), 65 percent for low-dose bilateral therapy (P = 0.001), and 63 percent for high-dose bilateral therapy (P = 0.001). Regardless of electrode placement, high dosage resulted in more rapid improvement.

Author:
Sackeim HA
Prudic J
Devanand DP
Kiersky JE
Fitzsimons L
Moody BJ
McElhiney MC
Coleman EA
Settembrino JM

Address: Department of Biological Psychiatry, New York State Psychiatric Institute, NY 10032.
Abbreviated Journal Title: N Engl J Med
Date Of Publication: 1993 Mar 25
Journal Volume: 328
Page Numbers: 839 through 846

Added: Jul 22, 2006 3:10 pm | Trackback URI |  Email This Post  | Print