title: Bifrontal versus bitemporal electroconvulsive therapy in severe manic patients.
abstract: OBJECTIVE
  To compare the efficacy and safety of moderate-dose bifrontal (BF) with low-dose bitemporal (BT) electroconvulsive therapy (ECT) in the treatment of patients with severe mania.
  
  
  METHODS
  In a parallel, double-blind, randomized clinical trial, 28 patients with severe mania admitted to a university hospital were assigned randomly to moderate-dose BF (n = 14) and low-dose BT (n= 14) ECT. The primary outcome measures included the Mini-Mental State Examination (MMSE) and the Young Mania Rating Scale (YMRS).
  
  
  RESULTS
  All patients received at least 6 sessions of ECT. The 2 groups did not show any difference in their baseline MMSE or YMRS scores (P > 0.05). There was a significant difference between the MMSE scores of the BF compared with the BT group after both the sixth ECT (P < 0.05) and final ECT treatments (P < 0.05). Young Mania Rating Scale scores did not differ between the 2 groups after either the sixth or the last ECT sessions (P > 0.05).
  
  
  CONCLUSIONS
  Moderate-dose BF ECT was as effective as BT ECT but was associated with fewer cognitive side effects in the treatment of patients with severe mania.
authors.affiliation: Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, Iran. barekatain@med.mui.ac.ir
authors.forename: Majid
authors.initials: M
authors.lastname: Barekatain
authors.forename: Leila
authors.initials: L
authors.lastname: Jahangard
authors.forename: Mohammad
authors.initials: M
authors.lastname: Haghighi
authors.forename: Farzad
authors.initials: F
authors.lastname: Ranjkesh
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology* / Q000628:therapy*; D003071:Cognition; D004311:Double-Blind Method; D004565:Electroconvulsive Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult