New TCD Research Shows Reduction in Side-Effects Associated with Electroconvulsive Therapy (ECT) for Depression
Posted on: 18 August 2010
A new study by Trinity College Dublin researchers shows that side-effects linked to memory and thought processes associated with electroconvulsive therapy (ECT) for depression are transient. Moreover, for the vast majority of people these cognitive functions significantly improve beyond pre-treatment levels soon after completing a course of ECT. The findings were published online this month in the international peer-reviewed scientific journal, Biological Psychiatry. The research was supported by funding from the Health Research Board in Ireland. TCD researchers Dr Maria Semkovska and Professor Declan McLoughlin, of the Department of Psychiatry and Trinity College Institute of Neuroscience, are co-authors of the study.
ECT is the most powerful treatment available for depression. Modern treatment involves applying a small electrical charge to the brain of an anaesthetised patient under medically controlled safe conditions. Repeated treatments induce several molecular and cellular changes in the brain that are believed to be important for its antidepressant mechanism of action. About 500 people are treated annually with ECT in Ireland and about 1 million worldwide. The most common indication is for severe depression that has proven resistant to antidepressant drugs and psychotherapies. ECT can be a life-saving treatment for people with catatonia and those who are actively suicidal or physically debilitated by depression.
Commenting on the findings, Research Professor of Psychiatry, Declan McLoughlin said: “ECT is undoubtedly highly clinically effective but, unfortunately, its use has been limited by stigma as well as genuine public concerns about side effects, especially upon memory function. In our study we systematically reviewed all of the peer-reviewed scientific literature on ECT. We pooled data from over 80 different studies, with nearly 3000 patients. We then performed a series of global statistical tests, or meta-analyses, on 24 different standardised neuropsychology tests performed both before and after a course of ECT. While it was not possible to meta-analyse studies of retrograde memory function (i.e. the ability to recall previously learned information), it was reassuring to establish that cognitive deficits associated with ECT are temporary and that performance on most tests actually improve and are better than before ECT began. Our findings have immediate clinical relevance and will help people with severe depression, their families and clinicians to make better informed treatment decisions about ECT.”