ECT plus Antidepressants: a Review

Out on PubMed this week was this study from Taiwan:
Comparison of the efficacy of ECT plus agomelatine to ECT plus placebo in treatment-resistant depression.

Lin CH, Yang WC, Chen CC, Cai WR.Acta Psychiatr Scand. 2020 May 15. doi: 10.1111/acps.13183. Online ahead of print.PMID: 32412097

The study included 97 patients and yielded completely negative results, no benefit acutely or in relapse prevention from adding agomelatine.

The authors concluded:
Adding agomelatine to ECT yielded comparable response/remission rates to ECT without agomelatine in the acute ECT phase. Starting agomelatine in combination with ECT did not seem to be more efficacious in preventing relapse than starting agomelatine after the acute ECT course. More research is needed to guide clinical recommendations.

ECT practice has gone from prohibiting concomitant use of antidepressant medications in the old days, to now often favoring such use, with the hope of some augmentation of antidepressant effect. This topic was recently reviewed in the article featured in the blog post of 4/30/2020:

The Efficacy and Safety of Concomitant Psychotropic Medication and Electroconvulsive Therapy (ECT).

Janjua AU, Dhingra AL, Greenberg R, McDonald WM.

CNS Drugs. 2020 Apr 27. doi: 10.1007/s40263-020-00729-1

Note that the antidepressant agomelatine was never approved for use in the USA. Note also that it is important to publish negative results.