Classics in ECT: Response to First ECT As a Predictor of Outcome, Indian Journal of Psychiatry, 1998
"Classics in ECT" brings you this study from 1998, in the Indian Journal of Psychiatry:
Response to first ECT in depression and its value as a predictor of response to ECT is a poorly researched subject. Twenty-two antidepressant-free patients of severe depression (ICD - 10) were administered a course of 6 ECTs using bilateral sine-wave electrical stimulation with serial assessments on Hamilton Depression Rating Scale (HDRS). Using 'a priori' definition for 'good response' (≥ 60% reduction is baseline HDRS scores) patients were grouped and analysed. The reduction in HDRS scores after first ECT was significantly greater for Good Responders (GR) in comparison to 'Poor responders'. It appeared that ≥ 9% reduction in baseline HDRS scores after the first ECT was associated with 'Good Response'. Thus, it can be concluded that response to first ECT could be taken as a viable predictor of response in depression.
Keywords: Electroconvulsive therapy; depression; predictor; response.
Response to first ect in depression : a predictor of outcome.
Indian J Psychiatry. 1998 Oct;40(4):322-6.PMID: 21494495
Response to first ECT in depression and its value as a predictor of response to ECT is a poorly researched subject. Twenty-two antidepressant-free patients of severe depression (ICD - 10) were administered a course of 6 ECTs using bilateral sine-wave electrical stimulation with serial assessments on Hamilton Depression Rating Scale (HDRS). Using 'a priori' definition for 'good response' (≥ 60% reduction is baseline HDRS scores) patients were grouped and analysed. The reduction in HDRS scores after first ECT was significantly greater for Good Responders (GR) in comparison to 'Poor responders'. It appeared that ≥ 9% reduction in baseline HDRS scores after the first ECT was associated with 'Good Response'. Thus, it can be concluded that response to first ECT could be taken as a viable predictor of response in depression.
Keywords: Electroconvulsive therapy; depression; predictor; response.
The pdf is here.
And from the text:
Here's a small and methodologically challenged study that, nonetheless, is a very interesting contribution to the ECT predictors-of-response literature. The idea of the "specialness" of the first ECT, both in terms of antidepressant potency and response prediction, is fascinating.
Subsequent data, some of them from the CORE and CORE/PRIDE studies, support these concepts.
The concern about the first (low stimulus dose) ECT in a dose titration session being "wasted" or ineffective is somewhat mitigated by these observations; that is, some data suggest that even weaker forms of ECT have substantial antidepressant effect at this "special" first treatment session. There is also a body of literature (both ECT and ECS) about the biological changes induced by a single, or first, ECT.
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