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Relapse prevention in major depressive disorder after successful ECT: a literature review and a naturalistic case series
Author(s) -
Wijkstra Jaap,
Nolen Willem A.,
Algra Ale,
Van Vliet Irene M.,
Kahn René S.
Publication year - 2000
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1034/j.1600-0447.2000.102006454.x
Subject(s) - electroconvulsive therapy , depression (economics) , major depressive disorder , treatment resistant depression , medicine , psychiatry , resistance (ecology) , schizophrenia (object oriented programming) , cognition , biology , economics , macroeconomics , ecology
Objective: Medication‐resistance in major depressive disorder (MDD) may be related to high relapse rates after successful ECT when continued medication (C‐MED) is used to prevent relapse. An alternative could be to continue ECT (C‐ECT). Method: Patients with medication‐resistant MDD responding to ECT were offered C‐ECT without medication. Follow‐up was 6 months. Publications from a literature search were screened against prespecified criteria. Results: With C‐ECT the 6‐month relapse‐rate was 50% (6/12, 95%CI:21–79) in our medication‐resistant group. In the review we found with C‐ECT 29% (7/24,CI:13–51) in ‘unknown’ medication resistance and no data about medication‐resistant depression. With C‐MED at 6 months: no data were found concerning medication‐resistant depression, 28% (35/124,CI:20–36) in ‘unknown’ resistance and 13% (2/15,CI:2–41) in non‐resistance. With C‐MED at 12 months, 73% (16/22,CI:50–90), 50% (16/32,CI:32–68) and 27% (8/30,CI:12–46) were found, respectively. Conclusion: The efficacy of C‐MED is related negatively to medication resistance before ECT. This may also be the case for C‐ECT. Further studies with C‐ECT are urgently needed.