title: Long-term treatment strategies in major depression: a 2-year prospective naturalistic follow-up after successful electroconvulsive therapy.
abstract: OBJECTIVE
  To describe a 2-year follow-up in a cohort of patients with major depressive disorder treated with pharmacotherapy plus a short-term course of electroconvulsive therapy (ECT) over the index episode.
  
  
  METHODS
  This naturalistic study included 127 patients. After remission, the same pharmacotherapy regimen was maintained in all patients, whereas 44 also received continuation/maintenance ECT (C/M-ECT). Demographic and clinical data were reported for patients with pharmacotherapy and patients with pharmacotherapy and C/M-ECT. The clinical course of the disorder was compared two years before and after index episode remission.
  
  
  RESULTS
  Continuation/maintenance ECT was more prescribed in men and in those patients with more previous episodes and admissions and higher treatment resistance. Longer duration of index episode and greater number of episodes in the previous 2 years were identified as risk factors for relapse/recurrence. Furthermore, in our sample, a significant improvement of the illness course after remission was observed after successful ECT.
  
  
  CONCLUSIONS
  Both treatments were effective as maintenance strategies for depressive patients who showed complete response to an acute ECT course. According to our observations, pharmacotherapy both alone and plus C/M-ECT may potentially be considered as long-term treatments after successful ECT in patients with severe major depressive disorder.
authors.affiliation: Neuroscience Group [Bellvitge Biomedical Research Institute-] IDIBELL, Mood, Disorders Clinical and Research Unit, Psychiatry Department, Bellvitge University, Hospital-ICS, L'Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain.
authors.forename: Erika
authors.initials: E
authors.lastname: Martínez-Amorós
authors.forename: Narcís
authors.initials: N
authors.lastname: Cardoner
authors.forename: Virginia
authors.initials: V
authors.lastname: Soria
authors.forename: Verònica
authors.initials: V
authors.lastname: Gálvez
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Menchón
authors.forename: Mikel
authors.initials: M
authors.lastname: Urretavizcaya
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000523:psychology / Q000628:therapy*; D004359:Drug Therapy, Combination; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D012044:Regression Analysis; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D000928:Antidepressive Agents