title: A randomized controlled trial of brief and ultrabrief pulse right unilateral electroconvulsive therapy.
abstract: BACKGROUND
  Some studies suggest better overall outcomes when right unilateral electroconvulsive therapy (RUL ECT) is given with an ultrabrief, rather than brief, pulse width.
  
  
  METHODS
  The aim of the study was to test if ultrabrief-pulse RUL ECT results in less cognitive side effects than brief- pulse RUL ECT, when given at doses which achieve comparable efficacy. One hundred and two participants were assigned to receive ultrabrief (at 8 times seizure threshold) or brief (at 5 times seizure threshold) pulse RUL ECT in a double-blind, randomized controlled trial. Blinded raters assessed mood and cognitive functioning over the ECT course.
  
  
  RESULTS
  Efficacy outcomes were not found to be significantly different. The ultrabrief group showed less cognitive impairment immediately after a single session of ECT, and over the treatment course (autobiographical memory, orientation).
  
  
  CONCLUSIONS
  In summary, when ultrabrief RUL ECT was given at a higher dosage than brief RUL ECT (8 versus 5 times seizure threshold), efficacy was comparable while cognitive impairment was less.
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, Australia (Drs Loo and Martin, Ms Katalinic, and Mr Hadzi-Pavlovic); St George Hospital and Wesley Hospital, Sydney, Australia (Dr Loo and Dr Simpson); Black Dog Institute, Sydney, Australia (Drs Loo and Martin, Ms Katalinic, and Mr Hadzi-Pavlovic); and Dr Simpson Department of Psychiatry, University of Melbourne, and The Melbourne Clinic, Melbourne, Australia (Ms Smith and Addison, Mr Dowling, and Dr Schweitzer); Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia (Dr Ingram). colleen.loo@unsw.edu.au.
authors.forename: Colleen K
authors.initials: CK
authors.lastname: Loo
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, Australia (Drs Loo and Martin, Ms Katalinic, and Mr Hadzi-Pavlovic); St George Hospital and Wesley Hospital, Sydney, Australia (Dr Loo and Dr Simpson); Black Dog Institute, Sydney, Australia (Drs Loo and Martin, Ms Katalinic, and Mr Hadzi-Pavlovic); and Dr Simpson Department of Psychiatry, University of Melbourne, and The Melbourne Clinic, Melbourne, Australia (Ms Smith and Addison, Mr Dowling, and Dr Schweitzer); Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia (Dr Ingram).
authors.forename: Natalie
authors.initials: N
authors.lastname: Katalinic
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, Australia (Drs Loo and Martin, Ms Katalinic, and Mr Hadzi-Pavlovic); St George Hospital and Wesley Hospital, Sydney, Australia (Dr Loo and Dr Simpson); Black Dog Institute, Sydney, Australia (Drs Loo and Martin, Ms Katalinic, and Mr Hadzi-Pavlovic); and Dr Simpson Department of Psychiatry, University of Melbourne, and The Melbourne Clinic, Melbourne, Australia (Ms Smith and Addison, Mr Dowling, and Dr Schweitzer); Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia (Dr Ingram).
authors.forename: Deirdre J
authors.initials: DJ
authors.lastname: Smith
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, Australia (Drs Loo and Martin, Ms Katalinic, and Mr Hadzi-Pavlovic); St George Hospital and Wesley Hospital, Sydney, Australia (Dr Loo and Dr Simpson); Black Dog Institute, Sydney, Australia (Drs Loo and Martin, Ms Katalinic, and Mr Hadzi-Pavlovic); and Dr Simpson Department of Psychiatry, University of Melbourne, and The Melbourne Clinic, Melbourne, Australia (Ms Smith and Addison, Mr Dowling, and Dr Schweitzer); Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia (Dr Ingram).
authors.forename: Anna
authors.initials: A
authors.lastname: Ingram
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, Australia (Drs Loo and Martin, Ms Katalinic, and Mr Hadzi-Pavlovic); St George Hospital and Wesley Hospital, Sydney, Australia (Dr Loo and Dr Simpson); Black Dog Institute, Sydney, Australia (Drs Loo and Martin, Ms Katalinic, and Mr Hadzi-Pavlovic); and Dr Simpson Department of Psychiatry, University of Melbourne, and The Melbourne Clinic, Melbourne, Australia (Ms Smith and Addison, Mr Dowling, and Dr Schweitzer); Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia (Dr Ingram).
authors.forename: Nathan
authors.initials: N
authors.lastname: Dowling
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, Australia (Drs Loo and Martin, Ms Katalinic, and Mr Hadzi-Pavlovic); St George Hospital and Wesley Hospital, Sydney, Australia (Dr Loo and Dr Simpson); Black Dog Institute, Sydney, Australia (Drs Loo and Martin, Ms Katalinic, and Mr Hadzi-Pavlovic); and Dr Simpson Department of Psychiatry, University of Melbourne, and The Melbourne Clinic, Melbourne, Australia (Ms Smith and Addison, Mr Dowling, and Dr Schweitzer); Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia (Dr Ingram).
authors.forename: Donel
authors.initials: D
authors.lastname: Martin
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, Australia (Drs Loo and Martin, Ms Katalinic, and Mr Hadzi-Pavlovic); St George Hospital and Wesley Hospital, Sydney, Australia (Dr Loo and Dr Simpson); Black Dog Institute, Sydney, Australia (Drs Loo and Martin, Ms Katalinic, and Mr Hadzi-Pavlovic); and Dr Simpson Department of Psychiatry, University of Melbourne, and The Melbourne Clinic, Melbourne, Australia (Ms Smith and Addison, Mr Dowling, and Dr Schweitzer); Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia (Dr Ingram).
authors.forename: Kerryn
authors.initials: K
authors.lastname: Addison
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, Australia (Drs Loo and Martin, Ms Katalinic, and Mr Hadzi-Pavlovic); St George Hospital and Wesley Hospital, Sydney, Australia (Dr Loo and Dr Simpson); Black Dog Institute, Sydney, Australia (Drs Loo and Martin, Ms Katalinic, and Mr Hadzi-Pavlovic); and Dr Simpson Department of Psychiatry, University of Melbourne, and The Melbourne Clinic, Melbourne, Australia (Ms Smith and Addison, Mr Dowling, and Dr Schweitzer); Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia (Dr Ingram).
authors.forename: Dusan
authors.initials: D
authors.lastname: Hadzi-Pavlovic
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, Australia (Drs Loo and Martin, Ms Katalinic, and Mr Hadzi-Pavlovic); St George Hospital and Wesley Hospital, Sydney, Australia (Dr Loo and Dr Simpson); Black Dog Institute, Sydney, Australia (Drs Loo and Martin, Ms Katalinic, and Mr Hadzi-Pavlovic); and Dr Simpson Department of Psychiatry, University of Melbourne, and The Melbourne Clinic, Melbourne, Australia (Ms Smith and Addison, Mr Dowling, and Dr Schweitzer); Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia (Dr Ingram).
authors.forename: Brett
authors.initials: B
authors.lastname: Simpson
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, Australia (Drs Loo and Martin, Ms Katalinic, and Mr Hadzi-Pavlovic); St George Hospital and Wesley Hospital, Sydney, Australia (Dr Loo and Dr Simpson); Black Dog Institute, Sydney, Australia (Drs Loo and Martin, Ms Katalinic, and Mr Hadzi-Pavlovic); and Dr Simpson Department of Psychiatry, University of Melbourne, and The Melbourne Clinic, Melbourne, Australia (Ms Smith and Addison, Mr Dowling, and Dr Schweitzer); Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia (Dr Ingram).
authors.forename: Isaac
authors.initials: I
authors.lastname: Schweitzer
mesh_terms: D000339:Affect; D003072:Cognition Disorders / Q000209:etiology; D003866:Depressive Disorder / Q000628:therapy*; D004311:Double-Blind Method; D004565:Electroconvulsive Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012640:Seizures / Q000209:etiology; D016896:Treatment Outcome
keywords: cognitive; depression; electroconvulsive therapy; pulse width; randomized controlled trial