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Less memory complaints with reduced stimulus dose during electroconvulsive therapy for depression
Psykiatri Nordväst, Stockholm County Council. Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, stockholm, Sweden; Stockholm Health Care Services, Stockholm County Council. Centrum för psykiatriforskning, Stockholm, Sweden.
Örebro University, School of Medical Sciences.ORCID iD: 0000-0001-7454-3065
Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden.
2019 (English)In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 259, p. 296-301Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Electroconvulsive therapy (ECT) is an effective treatment for depression, but there is risk of cognitive adverse events. This risk has been partially attributed to electrical charge, thus the optimal electrical stimulus dose is still under discussion. The aim of this study was to evaluate how the risk of subjective memory worsening was changed after lowering stimulus dose during ECT for patients with major depression.

METHOD: A retrospective register-based intervention study of the effects of reduced electrical charges for patients receiving ECT for depression was conducted. The primary outcome was subjective memory worsening and the secondary outcome change in effect on depressive symptoms.

RESULTS: A total of 154 patients were enrolled in the study (High dosage group: n = 57; Lower dosage group: n = 97). Subjective memory worsening after ECT occurred in 44% of patients in the high dosage group and in 25% of patients in the lower dosage group(p = 0.014). There was no significant between-group difference in the anti-depressive effect of ECT.

LIMITATIONS: The study was register-based and the two groups were not randomized. A large portion of patients were initially excluded due to missing data in the register. The study lacks a long-term follow up.

CONCLUSION: After implementing a change of treatment protocol, that lowered ECT stimulus doses from high to moderate, the occurrence of subjective memory worsening was significantly reduced without compromising treatment results.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 259, p. 296-301
Keywords [en]
Electroconvulsive therapy, Major depressive disorder, Memory
National Category
Clinical Medicine Psychiatry
Research subject
Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-75993DOI: 10.1016/j.jad.2019.08.064PubMedID: 31450138OAI: oai:DiVA.org:oru-75993DiVA, id: diva2:1347573
Available from: 2019-09-01 Created: 2019-09-01 Last updated: 2019-09-06Bibliographically approved

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