A report on mood and cognitive outcomes with right unilateral ultrabrief pulsewidth (0.3 ms) ECT and retrospective comparison with standard pulsewidth right unilateral ECT.
BACKGROUND
Electroconvulsive therapy (ECT) is a highly effective treatment for depression but its use is limited by the risk of cognitive side effects. This study explored the potential of a novel approach, ultrabrief pulsewidth (0.3 ms) right unilateral (RUL-UB) ECT, to minimise cognitive effects while preserving efficacy.


METHODS
Mood and neuropsychological functioning were objectively rated in 30 patients over a course of RUL-UB ECT at 6 times seizure threshold. Results (mood outcomes, ECT treatment parameters) were compared with a retrospectively assessed group of 30 age and gender matched patients who received RUL ECT (1.0 ms pulsewidth, 3.5 times seizure threshold) at the same hospital.


RESULTS
Six treatments of RUL-UB ECT resulted in relatively few cognitive side effects, compared to reports of previous studies. The number of responders did not differ between groups but significantly more treatments were required in the RUL-UB group, suggesting a slower speed of response.


CONCLUSIONS
Patients were not randomised to the two forms of ECT and data was obtained retrospectively in the RUL ECT comparison group.


CONCLUSIONS
This study suggests that RUL-UB ECT can be effective in treating depression while incurring lesser cognitive side effects than a commonly used form of RUL ECT, but a greater number of treatments may be required for response.
Loo
Colleen
C
School of Psychiatry, University of N.S.W., Australia. colleen.loo@unsw.edu.au
Sheehan
Patrick
P
Pigot
Melissa
M
Lyndon
William
W
D000328:Adult; D000339:Affect / Q000502:physiology*; D001288:Attention / Q000502:physiology; D001714:Bipolar Disorder / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D054022:Cerebrum / Q000503:physiopathology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D003865:Major Depressive Disorder / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D010364:Pattern Recognition, Visual / Q000502:physiology; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000502:physiology; D011930:Reaction Time / Q000502:physiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014706:Verbal Learning / Q000502:physiology; D014936:Word Association Tests