title: Maintenance electroconvulsive therapy up to 12 years.
abstract: BACKGROUND
  Maintenance electroconvulsive therapy (m-ECT) is effective in preventing recurrences of depressive episodes. There is little information on long-term m-ECT extending over several years and its impact on cognitive functions. This study was an attempt to determine the efficacy and side effects of long-term m-ECT.
  
  
  METHODS
  Depressive episodes and admissions before m-ECT for a period equal to the duration of m-ECT and during m-ECT were compared using medical records. Cognitive functions assessed by Mini-Mental State Examination (MMSE) before and after m-ECT were compared along with the review of Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG).
  
  
  RESULTS
  17 patients had m-ECT that extended from 6 to 153 months (mean 39, SD=44.46). The average number of episodes before and during m-ECT was 2.47 (SD=2.23) and 0.88 (SD=1.31) respectively (Wilcoxon ranked test Z=3.06, r=0.55, two-tailed p=0.002). Average number of admissions dropped from 2.05 (SD=1.88) to 0.23 (SD=0.43) during m-ECT (Z=3.471, r=0.71, p=0.001). The average time to recurrence was 24.24 months (SD=25.20) with longest depression free survival of 105 months. There was no significant difference in MMSE score before and after the commencement m-ECT or progressive deterioration in NUCOG score.
  
  
  CONCLUSIONS
  This study was limited by retrospective nature of data collection, small sample size, confounding effects of antidepressants along with m-ECT and absence of a highly sensitive cognitive screening tool that can capture all types of cognitive impairments following m-ECT.
  
  
  CONCLUSIONS
  In a naturalistic setting the efficacy of m-ECT may extend over several years while cognitive functions remain largely unaffected.
authors.affiliation: Rural Health Academic Centre, The University of Melbourne, Goulburn Valley Health Shepparton, Victoria 3630, Australia. Electronic address: alby.elias@unimelb.edu.au.
authors.forename: Alby
authors.initials: A
authors.lastname: Elias
authors.affiliation: Rural Health Academic Centre, The University of Melbourne, Goulburn Valley Health Shepparton, Victoria 3630, Australia.
authors.forename: Saji J
authors.initials: SJ
authors.lastname: Chathanchirayil
authors.affiliation: Rural Health Academic Centre, The University of Melbourne, Goulburn Valley Health Shepparton, Victoria 3630, Australia.
authors.forename: Ravi
authors.initials: R
authors.lastname: Bhat
authors.affiliation: New York State Psychiatric Institute, Columbia University, New York, NY, USA.
authors.forename: Joan
authors.initials: J
authors.lastname: Prudic
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology*; D003866:Depressive Disorder / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055502:Secondary Prevention; D013997:Time Factors
chemical_list: D000928:Antidepressive Agents
keywords: Cognitive deficits; Depression; ECT; Electroconvulsive therapy; Maintenance ECT