Ultra-Brief-Pulse Electroshock Effective for Severe Depression with Far Fewer Cognitive Side Effects Than Standard Electroshock

Electroconvulsive therapy (ECT) remains one of the most effective treatments for severe depression, but new University of New South Wales (UNSW) research shows ultra-brief pulse stimulation is almost as effective as standard ECT, with far fewer cognitive side effects. The study, published online in the Journal of Clinical Psychiatry, is the first systematic review to examine the effectiveness and cognitive effects of standard ECT treatment, brief pulse stimulation, versus the newer treatment, known as ultra-brief pulse right unilateral (RUL) ECT. It comes after previous trials had shown conflicting results. The latest study reviewed six international ECT studies comprising 689 patients with a median age of 50 years old. The study found that, while standard ECT was slightly more effective for treating depression and required one fewer treatment, this came at a cost with significantly more cognitive side effects. "This new treatment, which is slowly coming into clinical practice in Australia, is one of the most significant developments in the clinical treatment of severe depression in the past two decades," according to UNSW Professor of Psychiatry Dr. Colleen Loo. "Our analysis of the existing trial data showed that ultra-brief stimulation significantly lessened the potential for the destruction of memories formed prior to ECT, reduced the difficulty of recalling and learning new information after ECT, and was almost as effective as the standard ECT treatment," Professor Loo said. The article is titled "A Systematic Review and Meta-Analysis of Brief Versus Ultrabrief Right Unilateral Electroconvulsive Therapy for Depression." ECT delivers a finely controlled electric current to the brain's prefrontal cortex, an area that is underactive in people with depression.
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