[Electroconvulsive therapy in major depression: current aspects].
OBJECTIVE
The efficacy of electroconvulsive therapy in treating depressive symptoms has been established by means of innumerable studies developed along the last decades. Electroconvulsive therapy is the most effective biological treatment for depression currently available. The objective of this study was to demonstrate the role of electroconvulsive therapy in the treatment of depression and highlight present aspects related to its practice.


METHODS
We reviewed in the literature studies on efficacy, symptom remission, predictive response factors as well as current aspects regarding quality of life, the patients' perception, mechanism of action, technique and cognitive impairment.


RESULTS
The main results found in the this revision were: 1) electroconvulsive therapy is more effective than any antidepressant medication; 2) the remission of depression with electroconvulsive therapy varies, in general, from 50 to 80%; 3) The effect of electroconvulsive therapy in brain-derived neurotrophic factor levels is still controversial; 4) electroconvulsive therapy has a positive effect in the improvement of quality of life; 5) patients submitted to electroconvulsive therapy have, in general, a positive perception about the treatment.


CONCLUSIONS
Electroconvulsive therapy remains a highly efficacious treatment in treatment-resistant depression. With the improvement of its technique, electroconvulsive therapy has become an even safer and more useful procedure both for the acute phase and for the prevention of new depressive episodes.
Antunes
Paula Barros
PB
Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, and Programa de Esquizofrenia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil. antunespaula@hotmail.com
Rosa
Moacyr Alexandro
MA
Belmonte-de-Abreu
Paulo Silva
PS
Lobato
Maria Inês Rodrigues
MI
Fleck
Marcelo P
MP
D019208:Brain-Derived Neurotrophic Factor / Q000097:blood*; D003865:Major Depressive Disorder / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000009:adverse effects / Q000592:standards*; D006801:Humans; D015201:Meta-Analysis as Topic; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D019208:Brain-Derived Neurotrophic Factor