title: Acute antidepressant effects of right unilateral ultra-brief ECT: a double-blind randomised controlled trial.
abstract: BACKGROUND
  Shortening the pulse width to 0.3 ms holds neurophysiological and clinical promise of making ECT safer by limiting cognitive side effects. However, the antidepressant effects of right ultra-brief unilateral ECT are under contention. In an acute ECT course, antidepressant equivalence of ultra-brief right unilateral ECT to the high-dose brief pulse right unilateral ECT was investigated.
  
  
  METHODS
  Severely depressed patients were randomised to 1 ms-brief pulse (n=18) or 0.3 ms ultra-brief pulse (n=17) right unilateral ECT, both at high-dose (6 times threshold stimulus dose) given thrice weekly. Depression severity was measured using the Montgomery Asberg Depression Rating Scale at baseline, after 8 treatments and after the acute course of ECT.
  
  
  RESULTS
  Depression severity declined equally in both groups: F (1.27,41.97)=0.31, p=0.63. Median time in days to remission (95%CI) was in brief pulse ECT: 26 (18.6-33.4) and ultra-brief pulse ECT:28 (17.9-38.0).
  
  
  CONCLUSIONS
  The small sample study in the study increases the likelihood of type 2 error.
  
  
  CONCLUSIONS
  In severe depression, high-dose ultra-brief right unilateral ECT appears to show matching acute antidepressant response to an equally high-dose brief pulse right unilateral ECT.
authors.affiliation: Department of Psychiatry, Cumberland Hospital, Westmead, Australia. Prashanth_mayur@wsahs.nsw.gov.au
authors.forename: Prashanth
authors.initials: P
authors.lastname: Mayur
authors.forename: Karen
authors.initials: K
authors.lastname: Byth
authors.forename: Anthony
authors.initials: A
authors.lastname: Harris
mesh_terms: D000328:Adult; D003865:Major Depressive Disorder / Q000628:therapy*; D004311:Double-Blind Method; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome