2017 issue 2


Volume 33, issue 2

Original article

Assessment of the effectiveness of electroconvulsive therapy in treatment-resistant depression

Miłosz R. Krzywotulski1, Anna Bodnar-Czapiewska1, Maria Skibińska2, Anna Lewandowska1, Maria Chłopocka-Woźniak1, Janusz Rybakowski3
1. Klinika Psychiatrii Dorosłych w Poznaniu, Uniwersytet Medyczny w Poznaniu
2. Zakład Genetyki w Psychiatrii, Uniwersytet Medyczny w Poznaniu
3. Klinika Psychiatrii Dzieci i Młodzieży, Uniwersytet Medyczny w Poznaniu
Farmakoterapia w Psychiatrii i Neurologii 2017, 33 (2), 89–109
Date of publication: 20-11-2017
DOI: http://dx.medra.org/10.17393/fpn.2017.09.001
Keywords: treatment resistant depression, electroconvulsive therapy, bipolar affective disorder, unipolar affective disorder


Objectives. The aim of this study was to evaluate the effectiveness of ECT in treatment-resistant depression and to analyze the clinical, psychological and biochemical factors connected with that efficacy.

Material and methods. The study involved 80 patients treated in a psychiatric ward, with diagnosis of treatment-resistant depression, including 60 women and 20 men, aged 21–82 (mean 54) years, who underwent 6–16 (average 10) ECT treatments. There were 55 patients with bipolar affective disorder, 18 persons with unipolar affective disorder and 7 patients with depressive episode in the study. Clinical evaluation was performed using a 17-item Hamilton Depression Rating Scale.

Results. The average intensity of depression before treatment was 32 (SD = 6) points in this scale. A clinical improvement was defined as a reduction of intensity of depression of at least 50% in HDRS compared to baseline was attained in 56 (70%) patients. Remission, defined as a reduction in the severity of depression to a level of 7 points or less in HDRS score, was achieved in 25 (31%) patients. There was no significant relationship between efficacy (improvement and remission) and gender, age, diagnosis, duration of illness, duration of current episode, psychotic symptoms and prior lithium or venlafaxine treatment. There was worsening of some cognitive functions, including working and semantic memory, observed immediately after the treatment. ECT was more effective in patients with lower baseline BDNF levels and better results of some cognitive tests at the baseline.

Conclusions. These results confirm data from literature indicating that ECT therapy is effective for treatment-resistant depression.

Address for correspondence:
Miłosz Roman Krzywotulski
Klinika Psychiatrii Dorosłych w Poznaniu
ul. Szpitalna 27/33, 60-572 Poznań, Poland
email: mkszyfy@tlen.pl