The NSAID rofecoxib reduces subjective cognitive impairment associated with ECT

Electroconvulsive therapy (ECT) is regarded as one of the most effective treatments for major depression. Although it is generally well tolerated, a substantial number of patients complain of cognitive impairment such as forgetfulness, disorientation and confusion.

Several medications have been under investigation to reduce these side-effects, none of which were reported to be effective. Recently published animal data suggest a memory protective effect of the NSAID indomethacin in rats.

Based on these results we performed an observational study with 40 patients with major depression of whom 20 received Rofecoxib prior to each ECT-treatment besides their antidepressive medication. Cognitive impairment was measured by weekly mini mental state examination (MMSE), clinical impression and subjective patients report.

Patients receiving Rofecoxib reported less cognitive impairment directly after the treatment and during the ECT-course. Furthermore MMSE-scores were less impaired in these patients compared to controls.

In conclusion the pre-treatment with the NSAID Rofexocib prior to ECT seems to be a promising drug in reducing cognitive impairment associated with ECT.