This finding could alleviate one of the primary concerns about ECT – that it causes memory loss, said W. Vaughn McCall, M.D., M.S, professor and chairman of the Department of Psychiatry and Behavioral Medicine and the principal investigator for the study's Wake Forest Baptist site.
The full study appears in the current issue of the Archives of General Psychiatry, published today.
ECT uses an electrical stimulus to the brain to induce seizures. It is prescribed for patients with crisis-level severe depression – who are catatonic (people who are so slowed down that they stop moving, talking and eating) or suicidal – or for patients with major depression who have not responded to medication. Electrodes attached to the head deliver the stimulus and patients are anesthetized and receive muscle relaxants during the procedure.
Patients receiving ECT often experience some memory loss that usually improves within days of treatment.
Researchers wanted to find a way to increase the effectiveness of ECT while reducing the side effects of memory loss.
"Although ECT remains a powerful treatment, there is still a significant proportion of patients that do not respond – recent statistics show a 70 to 80 percent response rate," McCall said. "Even in patients who do respond, there still is a significant risk of relapse. Patients may become ill again with depression within a matter of weeks to a few months after ECT."
The study is the first of its size to evaluate the use of antidepressants with ECT. Because of a lack of prior information on the topic of combining antidepressant medications with ECT, the American Psychiatric Association has not recommended routinely combining antidepressants with ECT.
The research was studied at several sites including Wake Forest University School of Medicine, Columbia University in New York, Washington University in St. Louis, and the University of Pittsburgh. It was coordinated by researchers at Columbia.
After consenting to the treatment, 319 patients received either a placebo or one of two antidepressants: nortriptyline, an older, generic drug, or venlafaxine, a newer drug that is sold under the brand name EffexorTM. The patients also received at least one form of ECT – either bilateral, stimulating both sides of the brain, or unilateral, affecting only the right side to keep the stimulus away from the verbal learning centers in the left side of the brain. Unilateral ECT is generally believed to cause less memory loss than bilateral ECT, but some investigators believed that unilateral ECT did not treat the depression symptoms as well.
Following treatment, patients were evaluated using a series of tests for changes in their depression symptoms and for memory loss.
The researchers found that using either antidepressant during ECT improved depression more than ECT alone. Moreover, patients who received nortriptyline during ECT had fewer memory problems compared with the venlafaxine group. Researchers also found that using a high dose of unilateral ECT on the right side of the brain was as effective as or superior to treating depression with moderate-dose bilateral ECT and still spared memory loss.
"We've been doing research for the last 10 years to find a way to make unilateral stimulation work as well as bilateral," McCall said. "We finally did that in this study."
The next step in this line of research, McCall said, is to evaluate the long-term effects of the treatment.
Co-researchers on the study were Peter Rosenquist, M.D., of the School of Medicine; Harold A. Sackeim, Ph.D., Elaine M. Dillingham, B.A., Joan Prudic, M.D., and Thomas Cooper, M.A., all of the New York State Psychiatric Institute and Columbia University; Keith Isenberg, M.D., and Keith Garcia, M.D., of Washington University School of Medicine, in Saint Louis; and Benoit H. Mulsant, M.D., and Roger F. Haskett, M.D., of the Western Psychiatric Institute and Clinic and Department of Psychiatry at the University of Pittsburgh School of Medicine in Pennsylvania. Mulsant has a second affiliation with the Department of Psychiatry at the University of Toronto and Centre for Addiction and Mental Health, in Toronto, Canada; and Sackeim has a third affiliation with the Department of Radiology at Columbia University.
The study was funded in part by grants from the National Institutes of Health and Wyeth Pharmaceuticals. ECT equipment was loaned for use in the study by the MECTA Corp.
Media Relations Contacts: Jessica Guenzel, email@example.com, (336) 716-3487; Bonnie Davis, firstname.lastname@example.org, (336) 716-4977; or Shannon Koontz, email@example.com, (336) 716-4587.
Wake Forest University Baptist Medical Center (www.wfubmc.edu) is an academic health system comprised of North Carolina Baptist Hospital, Brenner Children's Hospital, Wake Forest University Physicians, and Wake Forest University Health Sciences, which operates the university's School of Medicine and Piedmont Triad Research Park. The system comprises 1,056 acute care, rehabilitation and long-term care beds and has been ranked as one of "America's Best Hospitals" by U.S. News & World Report since 1993. Wake Forest Baptist is ranked 32nd in the nation by America's Top Doctors for the number of its doctors considered best by their peers. The institution ranks in the top third in funding by the National Institutes of Health and fourth in the Southeast in revenues from its licensed intellectual property.
Jessica Guenzel | EurekAlert!
New imaging technique able to watch molecular dynamics of neurodegenerative diseases
14.07.2017 | The Optical Society
Quick test finds signs of sepsis in a single drop of blood
03.07.2017 | University of Illinois at Urbana-Champaign
Physicists have developed a new technique that uses electrical voltages to control the electron spin on a chip. The newly-developed method provides protection from spin decay, meaning that the contained information can be maintained and transmitted over comparatively large distances, as has been demonstrated by a team from the University of Basel’s Department of Physics and the Swiss Nanoscience Institute. The results have been published in Physical Review X.
For several years, researchers have been trying to use the spin of an electron to store and transmit information. The spin of each electron is always coupled...
What is the mass of a proton? Scientists from Germany and Japan successfully did an important step towards the most exact knowledge of this fundamental constant. By means of precision measurements on a single proton, they could improve the precision by a factor of three and also correct the existing value.
To determine the mass of a single proton still more accurate – a group of physicists led by Klaus Blaum and Sven Sturm of the Max Planck Institute for Nuclear...
The research team of Prof. Dr. Oliver Einsle at the University of Freiburg's Institute of Biochemistry has long been exploring the functioning of nitrogenase....
A one trillion tonne iceberg - one of the biggest ever recorded -- has calved away from the Larsen C Ice Shelf in Antarctica, after a rift in the ice,...
Physics supports biology: Researchers from PTB have developed a model system to investigate friction phenomena with atomic precision
Friction: what you want from car brakes, otherwise rather a nuisance. In any case, it is useful to know as precisely as possible how friction phenomena arise –...
21.07.2017 | Event News
19.07.2017 | Event News
12.07.2017 | Event News
21.07.2017 | Earth Sciences
21.07.2017 | Power and Electrical Engineering
21.07.2017 | Physics and Astronomy