title: Impacts of switching antidepressants after successful electroconvulsive therapy on the maintenance of clinical remission in patients with treatment-resistant depression: a chart review.
abstract: BACKGROUND
  There is no consensus regarding whether a previously prescribed, that is, failed, antidepressant should be continued or switched after a successful electroconvulsive therapy (ECT) for the maintenance of clinical remission in patients with treatment-resistant depression (TRD). In this study, we conducted a chart review to examine impacts of the antidepressant switch after the successful ECT on 1-year outcome in patients with TRD.
  
  
  METHODS
  This retrospective chart review included inpatients with TRD (ie, those who failed to respond to adequate trials of 2 distinctly different classes of antidepressants) who showed clinical remission after ECT. Readmission rate and social functioning 6 months and 1 year after the successful ECT were compared between patients who experienced an antidepressant switch and those who continued prior regimen.
  
  
  RESULTS
  Twenty-eight patients (mean age, 59 years; 9 men) were followed-up for 1 year. The patients who changed antidepressants after ECT (n = 7) experienced a readmission significantly less frequent than the others (n = 21) in 1 year (0% vs 43%, P = 0.043). In addition, the former showed significantly better social contacts at 6 months (P = 0.022) and 1 year (P = 0.015). There were no significant differences in baseline characteristics between the 2 groups.
  
  
  CONCLUSIONS
  The patients who experienced an antidepressant switch after ECT required a readmission less frequently in 1 year than those who were maintained with the same antidepressant. The findings of this preliminary study suggest that a switch to another antidepressant after successful ECT may be encouraged for the maintenance of clinical remission in patients with TRD.
authors.affiliation: Oizumi Hospital and daggerDepartment of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan. shinichiro_nakajima@hotmail.com
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Nakajima
authors.forename: Takuto
authors.initials: T
authors.lastname: Ishida
authors.forename: Rei
authors.initials: R
authors.lastname: Akaishi
authors.forename: Keisuke
authors.initials: K
authors.lastname: Takahata
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Kitahata
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Uchida
authors.forename: Takefumi
authors.initials: T
authors.lastname: Suzuki
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Takeuchi
authors.forename: Kensuke
authors.initials: K
authors.lastname: Nomura
authors.forename: Atsuo
authors.initials: A
authors.lastname: Nakagawa
authors.forename: Koichiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Haruo
authors.initials: H
authors.lastname: Kashima
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D004351:Drug Resistance; D004565:Electroconvulsive Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012919:Social Behavior
chemical_list: D000928:Antidepressive Agents; D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic