Classics in ECT: Lithium Prophylaxis After ECT: Earliest Report

"Classics in ECT" brings you this paper from 1979:

Treatment of unipolar depression following electroconvulsive therapy. Relapse rate comparisons between lithium and tricyclics therapies following ECT.

Perry P, Tsuang MT.J Affect Disord. 1979 Jun;1(2):123-9. doi: 10.1016/0165-0327(79)90031-4.PMID: 162494

The pdf is here.

And from the text:

And from the "Discussion":

Therefore, one of the expected benefits in treating depression with ECT followed by either tricyclic or lithium prophylaxis may well be the decreased risk of suicide and suicide attempts among such patients.

This is a small retrospective study (total n=54, (34 TCA, 20 lithium)) demonstrating good post-ECT relapse prevention with pharmacotherapy, either a tricyclic antidepressant or lithium. This is the earliest such lithium data found by Lambrichts et al. in their recent Acta Psychiatrica Scandinavica meta-analysis of post-ECT lithium prophylaxis.

The mention of  citations of maintenance ECT from the very early literature (see "Introduction" text above) and speculation of suicide reduction by lithium or TCA in the "discussion" are interesting details of this paper.

This paper is worth a full read (~10 minutes).

[Ming Tsuang is a renowned psychiatric researcher with hundreds of PubMed citations, mostly on schizophrenia and a handful of them on ECT. Paul Perry, now at Touro University College of Pharmacy in California, is a pharmacist who has written widely on psychotropics, but only has a couple of ECT-related citations.]

(See also tomorrow's blog post re Coppen et al. 1981 paper on continuation therapy with lithium post ECT.)