OPTIMIZATION OF ELECTROCONVULSIVE THERAPY

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。目的：电休克治疗（ECT）的提供者不确定在ECT期间是否应该继续使用抗抑郁药物，以及什么剂量的电对患者最好。该项目将检查服用抗抑郁药物的患者与未服用这些药物的患者在ECT后是否有不同的结果。我们还将研究ECT期间的药物状况是否能预测ECT后前6个月复发的可能性。研究对象：630名抑郁症成年人，多中心试验。维克森林大学每年随机抽取大约30名。方法和措施：患者将被随机分配（就像抛硬币一样），接受头部右侧的高剂量电流或两侧的低剂量电流。在电痉挛治疗期间，他们将同时随机接受安慰剂（如糖丸）、文拉法辛或去甲替林的治疗。电痉挛治疗后，所有有反应的患者和服用安慰剂的患者应接受vanlafizine或nortrityline治疗。最后，所有对ECT有反应的人都应该在他们的药物治疗方案中添加锂。我们将在ECT结束时测量情绪状态，记忆功能和生活质量，并在ECT结束后的6个月内每两周测量一次。在整个研究过程中应监测精神活性药物的血液水平。益处和风险：参与者在整个参与过程中将获得免费药物和血液药物水平。此外，ect后随访阶段的参与者将有免费的精神科办公室访问。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Purpose: Electroconvulsive therapy (ECT) providers are uncertain whether antidepressant medications should be continued during ECT, and what dose of electricity is best for the patient. This project will examine whether patients on antidepressant medications have different results after ECT compared with ECT patients who did not take these medications. We shall also examine whether medication status during ECT predicts the likelihood of relapse in the first 6 months after ECT. Subjects: 630 depressed adults in a multicenter trial. Approximately 30/year randomized at Wake Forest University. Methods and Measures: Patients will be randomized (like the flip of a coin) to receive either a high dose of electricity to the right side of their head or a low dose to both sides. They will simultaneously be randomized to placebo (like a sugar pill), venlafaxine, or nortriptyline during ECT. After ECT, all patients who responded and who had been on placebo shall receive either vanlafizine or nortriptyline. Finally, all responders to ECT shall have lithium added to their medication regimen. We will measure mood state, memory function, and quality of life at the end of ECT, and biweekly through 6 months after ECT. Blood levels of psychoactive medications shall be monitored throughout the study. Benefits and Risks: Participants shall get free medications and blood levels of medications throughout their participation in the protocol. Additionally, participants in the post-ECT follow up phase shall have free psychiatric office visits.