ECT Review From Romania
Out on PubMed, from authors in Romania, is this review:
Efficacy of electroconvulsive therapy as a potential first-choice treatment in treatment-resistant depression (Review).
Exp Ther Med. 2021 Nov;22(5):1281. doi: 10.3892/etm.2021.10716. Epub 2021 Sep 9.PMID: 34630636
The abstract is copied below:
Electroconvulsive therapy (ECT) is a technique that has been used since 1938 to treat several psychiatric disorders as a replacement for chemically induced seizures. Despite its history of stigma, controversy and low accessibility, ECT is found to be beneficial and efficient in severe cases of depression where medication fails to bring results. Titration tables developed over time, based on evidenced-based medicine, have made this treatment technique safe and, in some cases, the first choice of treatment. The aim of the review was to summarize the research conducted on the efficacy of ECT on major depressive disorder and variables studied such as technique, comorbidities and medication as well as the effects and outcomes of this procedure. At the same time, the application and correlations with other psychiatric and neurological disorders, including catatonia, agitation and aggression in individuals with dementia, schizophrenia, and epilepsy were assessed. There are no statistically demonstrated effects due to the fact that a small number of moderate-quality studies have been published; however, the combination of ECT technique with standard medication and care, can improve patient outcome. Furthermore, with regard to ECT, widespread and robust volume changes in both cortical and subcortical regions have been shown. Antidepressant response and volumetric increases appear to be limited by the specific neuroplasticity threshold of each patient.
Keywords: amnesia; ketamine; major depressive disorder; relapse; treatment dosage.
The pdf is here.
I approached this review with enthusiasm, and the beginning is promising. Unfortunately, it is very uneven, and has much inaccurate and inexpert interpretation of the literature. Here is one example: in a section entitled, "ECT in Epilepsy":
In short, it is premature to suggest that ECT is potentially dangerous, but routine EEG should be performed for patients receiving this therapy based on these observations. Well‑designed studies are needed to establish any potential relationship between ECT and epilepsy.
This review is likely a good-faith attempt to summarize major segments of the ECT literature, but it falls short, and cannot be recommended. That said, I would be grateful if blog followers read it and let us know if you share the above opinions, thanks.
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