ECT Appears More Effective than Antidepressant Drug Therapy For the treatment of acutely depressed hospitalised patients

In a retrospective study, the hospital records of 1495 patients with depression were used to classify patients as those treated by electroconvulsive therapy (ECT; n = 448), adequate antidepressant treatment (~ 4 weeks' treatment with ~ 2 weeks at specified dose levels; 246), inadequate antidepressant treatment (478) or those receiving neither antidepressants nor electroconvulsive therapy (323). Patient groups were found not to be comparable. The ECT-treated group was significantly different from the other groups in that they were older; included a higher percentage of patients with major depressive disorders, primary depression or delusions; they had more prior hospitalisations and longer hospitalisation, and they were more likely to have had onset of illness at ~ 20 years of age.

ECT caused marked improvement in 70% of patients, which was a significantly higher rate than that seen in patients receiving adequate (48%) or inadequate (50%) antidepressant treatment and in those

rece1vmg no treatment (45%) When the groups were stratified according to sex. age. durat1on ot Illness and subclasses of depression. ECT produced marked improvement more frequently than other treatments. Similar results were seen with unilateral. bilateral or mixed ECT treatments. 76% of pat1ents having 5-9 ECT treatments showed marked improvement compared w1th 45% of those rece1v1ng < 5 treatments (p < 0 05). 65% of those rece1v1ng 10-15 treatments and 54% of those rece1ving > 15 treatments. ECT was most effect1ve m the treatment of schizoaffect1ve disorders and 1n pat1ents over 40 years of age, producing marked improvement 1n 85 and 74% of pat1ents. respectively

The authors concluded that. although the treatment groups were not comparable at basel1ne. ECT appeared to be s1gn1f1cantly more effect1ve than antidepressants m the treatment of acutely depressed hosp1tal1sed patients 'We hope that this and other studies will encourage more sophisticated research in the use of ECT.' Black OW W1nohw G '-lasrallah A Comprchens,,e Ps,Chlalr, 28 169 182 ~/ar Apr 1987

12 INPHARMA • 30 May 1987 0156-2703/87/0530-0012/0$01.00/0 © ADIS Press