ECT vs Ketamine: NEJM Article Sets Up False Equivalency

Out on Pubmed recently is this study from Norway:


A Longitudinal Comparison Between Depressed Patients Receiving Electroconvulsive Therapy and Healthy Controls on Specific Memory Functions.

Blomberg MO, Semkovska M, Kessler U, Erchinger VJ, Oedegaard KJ, Oltedal L, Hammar Å.

Prim Care Companion CNS Disord. 2020 May 14;22(3). pii: 19m02547. doi: 10.4088/PCC.19m02547.

PMID:

 

32408397

 

The pdf is freely available to all on PubMed.

This study involved 38 patients treated for depression with brief pulse RUL ECT at Haukeland University Hospital in Bergen, Norway. There were also 16 healthy controls. Memory functions were assessed at baseline, acutely after ECT and at 6 months.

The main results were that patients scored worse on all measures of verbal and visual memory

functions at baseline, and that these measures were stable for patients at each time point.

Based on the AMI-SF, "patients displayed decreased autobiographical

(memory) consistency 6 months posttreatment." 

The authors concluded, "On the basis of our results, patients can be informed that everyday

memory functions are presumed to be unaffected by treatment. The ability to acquire new information  and knowledge is not reduced."

Overall these results are reassuring and consistent with most previous literature. The decrease in autobiographical memory consistency is of unclear clinical significance and the AMI-SF is a controversial instrument.

Placing the small cognitive  tolerability effects of ECT in the context of relief from a life-disrupting illness points to a very favorable risk-reward calculation for ECT. For a commentary about this, see:
 Electroconvulsive therapy and cognition: a salutary reappraisal.

Kellner CH, Farber KG. Acta Psychiatr Scand. 2016 Dec;134(6):459-460. The pdf is here.