Determination of predictors of twelve treatments (four weeks) outcome of titrated moderately suprathreshold (low dose) right unilateral (RUL) electroconvulsive therapy (ECT) in depression: a two year retrospective analysis

ECT is an effective short-term treatment for depression, which appears to be more effective than drug therapy in subgroups of depressed patients. However, as for drug treatment, robust predictors of individual response to ECT have not been established. For drug treatment, early improvement has recently been found to be highly predictive of therapeutic outcome (1). In this retrospective study we hypothesized, analogous to antidepressant pharmacotherapy, that early improvement predicts later antidepressant response in ECT course. We sought to determine the optimal duration of low dose RUL ECT to predict non response and thus optimal time to change treatment regimens. Changes of individual HAMD scores after the third (one week), sixth (two weeks) and ninth (three weeks) ECT treatment were tested as predictors of outcome after twelve (four weeks) ECT treatment. Moreover, the possible predictive value of variables like concomitant medication, age at onset of illness, numbers of episodes, anaesthetic medication, comorbidity, as well as side effects were tested. The data of this two years retrospective analysis will be presented.

1. Szegedi A, Müller MJ, Anghelescu I, et al. Early improvement under mirtazapine and paroxetine predicts later stable response and remission with high sensitivity in patients with major depression. J Clin Psychiatry (United States), Apr 2003, 64(4) p413–20