Classics in ECT: Meta-Analysis of Treatments For Psychotic Depression, J Affective Disorders, 1992

"Classics in ECT" brings you this meta-analysis from 1992: 


Psychotic (delusional) depression: a meta-analysis of physical treatments.

Parker G, Roy K, Hadzi-Pavlovic D, Pedic F.J Affect Disord. 1992 Jan;24(1):17-24. doi: 10.1016/0165-0327(92)90056-c.PMID: 1347545

The pdf is here.

The abstract is copied below:

Literature reviews have suggested that combination antidepressant/antipsychotic drug therapy and electroconvulsive therapy (ECT) are of comparable efficacy in treating psychotic depression, and distinctly superior to antidepressant alone or antipsychotic alone. We undertook a meta-analysis of 44 studies, and focussed on those three principal treatment options. There was a trend for ECT to be superior to combination drug therapy, with bilateral ECT being suggested as distinctly more effective than unilateral, and ECT was demonstrated to be significantly superior to tricyclic drug alone. Combination drug therapy ranked as more effective than antipsychotic alone and than antidepressant alone, but that greater efficacy was not significant.


And from the text:









This is an early meta-analysis, showing the superiority of ECT over medication treatment for psychotic depression. Despite the data, the tone is a bit negative about ECT, because "ECT is distressing for patients." As if being psychotically depressed is not distressing...
More recent data certainly confirm the efficacy of ECT for psychotic depression. 
A full read of this paper, ~15 minutes, is recommended for all students/scholars of psychotic depression and its treatments.

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