title: Medication Outcome in ECT-Resistant Depression.
abstract: The outcome of antidepressant treatment in 12 cases of electroconvulsive therapy (ECT)-resistant depression is presented. Eight patients had been refractory to a clinically adequate course of ECT (Hamilton Depression Scale improvement <20%) and four were partial responders (improvement 20-49%). All remitted completely on antidepressant medication within 2.2 +/- 1.1 (mean +/- SD) months of the ECT course. Remission was associated with clomipramine treatment (139 +/- 49.7 mg/day) in seven cases and maprotiline (125 mg/day) in one case. Four patients who did not respond to a tricyclic antidepressant alone remitted following supplementation (of clomipramine in 2 cases, clomipramine + haloperidol in 1 case, and imipramine in 1 case) with lithium carbonate. Although a delayed therapeutic response to ECT cannot be excluded, the results suggest that ECT may alter the sensitivity of refractory patients to antidepressant medication.
authors.affiliation: Jerusalem Mental Health Center, Ezrath Nashim Hospital, Jerusalem, Israel.
authors.forename: Baruch
authors.initials: B
authors.lastname: Shapira
authors.forename: Seth
authors.initials: S
authors.lastname: Kindler
authors.forename: Bernard
authors.initials: B
authors.lastname: Lerer