title: Inefficacy of burst-suppression anesthesia in medication-resistant major depression: a controlled trial.
abstract: Burst-suppression anesthesia (BSA) has been previously compared with electroconvulsive therapy (ECT) in drug-resistant depression, with promising results. We have carried out a double-blind randomized clinical trial comparing BSA with sham-BSA in 20 patients meeting DSM-IV criteria for major depression with inadequate response to antidepressant drugs and who chose BSA as an alternative to ECT. After withdrawing antidepressant drugs, patients were randomized to receive four sessions of either BSA (induction with propofol followed by the anesthetic agent sevoflurane, achieving BSA for 1 hour) or sham-BSA (induction with propofol until loss of consciousness, followed by spontaneous awakening in 5-10 minutes). Decrease in the Hamilton Rating Depression Scale was larger with BSA (-6.0 +/- 7.3) than with sham-BSA (-2.5 +/- 4.5), but differences did not reach statistical significance ( t = -1.08, p = 0.3). In our sample, we have not found BSA to be superior to sham-BSA and therefore cannot consider BSA as an alternative to ECT.
authors.affiliation: Department of Psychiatry, Complejo Hospitalario de Mallorca, Mallorca, Spain. magato@intersalud.es
authors.forename: M
authors.initials: M
authors.lastname: García-Toro
authors.forename: C
authors.initials: C
authors.lastname: Segura
authors.forename: A
authors.initials: A
authors.lastname: González
authors.forename: J
authors.initials: J
authors.lastname: Perelló
authors.forename: J
authors.initials: J
authors.lastname: Valdivia
authors.forename: R
authors.initials: R
authors.lastname: Salazar
authors.forename: G
authors.initials: G
authors.lastname: Tarancón
authors.forename: F
authors.initials: F
authors.lastname: Campoamor
authors.forename: J
authors.initials: J
authors.lastname: Salva
authors.forename: L
authors.initials: L
authors.lastname: De La Fuente
authors.forename: M
authors.initials: M
authors.lastname: Romera
mesh_terms: D000328:Adult; D000758:Anesthesia / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000494:pharmacology*; D000928:Antidepressive Agents / Q000494:pharmacology; D003866:Depressive Disorder / Q000628:therapy*; D004311:Double-Blind Method; D004351:Drug Resistance; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage / Q000494:pharmacology*; D014473:Unconscious, Psychology
chemical_list: D018686:Anesthetics, Intravenous; D000928:Antidepressive Agents; D015742:Propofol