Classics in ECT: Abrams-Sackeim LTE Exchange in JAMA, in 2001
"Classics in ECT" brings you this letter exchange from JAMA, in 2001:
Relapse of depression after electroconvulsive therapy.
JAMA. 2001 Jun 27;285(24):3087; author reply 3088-9.PMID: 11427126
The pdf is here.
And here:
I present this classic LTE exchange not so much for the details of the content, but to remind us of the back-and-forth between two
eminent ECT researchers. Dick Abrams is retired and well, but no longer academically active; he was a voice for evidence- and experienced-based ECT practice gained from a long career in research and direct ECT practice. (The intervening Doraiswamy letter is about SSRIs and relapse prevention.)
The below comment is from Dr. Max Fink:
ReplyDeleteAbrams-Sackeim Letters October 1, 2022
The 2001JAMA letters on the efficacy of ECT that highlighted the advantages of bilateral electrode placement led to an NIMH call for a comparison of RUL and BT placements. By 1997 two groups carried out ECT comparisons of the same ECT courses in multiple sites with the same evaluation criteria in hospitalized MDD patients with one group using RUL placement in the CUC group and BT placement in the CORE group.
Psychotic depressed responded 95% to BT, 63% for RUL placement, and 84% for BT placement. After one month there was no advantage in memory tests. The inefficacy of RUL placement does not justify their routine use. Abrams anticipation of poorer outcomes with RUL placement in 2001 is justified by extensive studies (Fink M, Taylor MA Electroconvulsive therapy: Evidence and challenges. JAMA 2007; 298: 330-332.)
Max Fink, MD