Antidepressant and cognitive effects of twice- versus three-times-weekly ECT.
Antidepressant and cognitive effects of twice- versus three-times-weekly ECT.
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DOI：
10.1176/ajp.152.4.564
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发表时间：
1995-04
期刊：
影响因子：
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通讯作者：
B. Lerer;B. Shapira;A. Calev;N. Tubi;H. Drexler;S. Kindler;D. Lidsky;Joseph E. Schwartz
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文献类型：
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作者：
B. Lerer;B. Shapira;A. Calev;N. Tubi;H. Drexler;S. Kindler;D. Lidsky;Joseph E. Schwartz
目的：本研究的目的是确定两种常用的ECT给药方案，每周两次或每周三次，在抗抑郁疗效和认知效应方面是临床最佳的。方法在这项双盲研究中，52名同意、无需药物的内源性亚型重性抑郁症（研究诊断标准）患者被随机分配接受双侧、短脉冲、恒流ECT治疗，持续4周，每周三次或每周两次，每周添加一次模拟ECT（仅麻醉剂和肌肉松弛剂）。结果测量采用汉密尔顿抑郁评定量表、急性认知效应成套测验和慢性认知效应成套测验。结果：两种治疗方案均显著改善了汉密尔顿抑郁量表评分，ECT系列治疗结束后1周或1个月的结局无差异。然而，每周三次ECT的反应速度明显更快，并且与真实的ECT给药速度有关。每周三次ECT的认知效果更突出。结论：ECT每周两次是一种有效的临床实践时间表，并考虑到与ECT每周三次相同的治疗结果和较不严重的认知影响，具有潜在的优势。当临床效果的早期发作是首要的时，每周三次的ECT可能特别适用。
OBJECTIVE The purpose of this study was to determine which of the two commonly used schedules of ECT administration, twice or three times weekly, is clinically optimal in terms of antidepressant efficacy and cognitive effects. METHOD In this double-blind study, 52 consenting, medication-free patients with major depressive disorder, endogenous subtype (Research Diagnostic Criteria), were randomly assigned to bilateral, brief-pulse, constant-current ECT administered over 4 weeks at a rate of three times weekly or twice weekly with the addition of one simulated ECT (anesthesia and muscle relaxant only) per week. Outcome measures were the Hamilton Depression Rating Scale, Acute Cognitive Effects Battery, and Chronic Cognitive Effects Battery. RESULTS Hamilton depression scale scores were significantly improved by both schedules, with no difference in outcome either 1 week or 1 month after the end of the ECT series. However, the rate of response to ECT three times a week was significantly faster and was related to the rate of real ECT administration. Cognitive effects were more prominent with ECT three times a week. CONCLUSIONS ECT twice a week is an effective schedule for clinical practice and is potentially advantageous in view of a therapeutic outcome identical to that of ECT three times a week and less severe cognitive effects. ECT three times a week may be specifically indicated when early onset of clinical effect is of primary importance.