Comment on Amplitude Titration Study in Neuropsychopharmacology
Out on PubMed, from authors in Minnesota, is this commentary:
Advances in precision neuromodulation: electroconvulsive therapy amplitude titration.
Neuropsychopharmacology. 2024 Jan 9. doi: 10.1038/s41386-024-01797-3. Online ahead of print.PMID: 38195909
The article is here.
And here.
So here is a commentary about the Abbott et al. article I discussed yesterday on the blog. It nicely summarizes the study, as well as its limitations.
To simplify, standard ECT is too powerful for some patients, so it is helpful to be able to offer less powerful treatments to other patients.
E-field may be a good measure of "strength," or "power," but at present can only be crudely estimated, or require complicated additional investigations for better estimates. Is electrical dosing analogous to milligram dosing with pharmaceuticals? To a certain extent, yes. With drugs, most patients get the same dose in a pill; only when drugs are given IV are they sometimes tailored to the individual by weight. While this may not be optimal or "personalized," it works well for most.
From a slightly different perspective, the strength of ECT is its remarkable strength; many ECT patients are desperately ill and need full strength treatment. It would be great to have both power and optimized tolerability, which is the aim of the described research. Until that goal is achieved, lets remember that efficacy tops (valid) concerns about transient cognitive effects.
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