Efficacy of electroconvulsive therapy as a potential first‑choice treatment in treatment‑resistant depression (Review)
- Simona Trifu
- Anca Sevcenco
- Monica Stănescu
- Ana Miruna Drăgoi
- Mihai Bogdan Cristea
Affiliations: Department of Clinical Neurosciences, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Faculty of Psychology and Educational Sciences, University of Bucharest, 050663 Bucharest, Romania, Department of Psychiatry, ‘Prof. Dr. Alex. Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania, Department of Morphological Sciences, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Published online on: September 9, 2021 https://doi.org/10.3892/etm.2021.10716
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Electroconvulsive therapy (ECT) is a technique that has been used since 1938 to treat several psychiatric disorders as a replacement for chemically induced seizures. Despite its history of stigma, controversy and low accessibility, ECT is found to be beneficial and efficient in severe cases of depression where medication fails to bring results. Titration tables developed over time, based on evidenced‑based medicine, have made this treatment technique safe and, in some cases, the first choice of treatment. The aim of the review was to summarize the research conducted on the efficacy of ECT on major depressive disorder and variables studied such as technique, comorbidities and medication as well as the effects and outcomes of this procedure. At the same time, the application and correlations with other psychiatric and neurological disorders, including catatonia, agitation and aggression in individuals with dementia, schizophrenia, and epilepsy were assessed. There are no statistically demonstrated effects due to the fact that a small number of moderate‑quality studies have been published; however, the combination of ECT technique with standard medication and care, can improve patient outcome. Furthermore, with regard to ECT, widespread and robust volume changes in both cortical and subcortical regions have been shown. Antidepressant response and volumetric increases appear to be limited by the specific neuroplasticity threshold of each patient.