Classics in ECT: Lithium Continuation After ECT, 1981
"Classics in ECT" brings you this study from the British Journal of Psychiatry in 1981:
Lithium continuation therapy following electroconvulsive therapy.
Br J Psychiatry. 1981 Oct;139:284-7. doi: 10.1192/bjp.139.4.284.PMID: 6799032
The abstract is copied below:
Thirty-eight depressed patients who were treated with ECT were randomly assigned to receive lithium therapy or identical-looking placebo tablets for one year after clinical recovery in a double-blind trial. The patients who received placebo tablets spent an average of 7.8 weeks with an episode of depression (either as in-patients or day-patients) during the year. In comparison, patients who received lithium spent on average 1.7 weeks with an episode (P less than 0.02). The trial confirms the high rate of relapses after ECT and suggests that lithium considerably reduces this morbidity. It is suggested that ECT without continuation therapy is not a satisfactory treatment of depressive illness.
The pdf is here.
And from the text:
This is a straightforward medium-sized, double blind, prospective trial of lithium for relapse prevention after a successful course of ECT for depression. Full lithium levels (0.8-1.2 mm/l) were administered. The authors note that the beneficial effect of lithium may take some time to reach maximal efficacy, getting stronger in the second six-month period.
The study was carried out in hospitals in Epsom (a town in Surrey, southwest of London) and Birmingham.
This study is the second earliest in the recent meta-analysis of lithium prophylaxis from Lambrichts et al. (Perry and Tsuang (yesterday's blog post) was the earliest (1979), but was retrospective.)
Alec Coppen was a renowned British psychiatric researcher who contributed extensively to the scientific understanding of antidepressants and lithium; he died at the age of 96 in 2019.
This short paper is clearly written and presented, definitely worth a full read (~10 minutes).
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