New Brain Stimulation Method Treats Severe Depression With Fewer Side Effects
Electroconvulsive therapy may currently be one of the most effective treatments for severe depression, but a new study published in the Journal of Clinical Psychiatry shows ultra-brief pulse stimulation is nearly as effective as standard ECT without many of the cognitive side effects.
The study is the first systematic review to assess the effectiveness and cognitive effects of standard ECT treatment, known as brief pulse stimulation, against ultra-brief pulse right unilateral (RUL) ECT. It reviewed six international ECT studies comprising 689 patients with a median age of 50 years old.
According to the findings, standard ECT was slightly more effective for treating depression and required one less treatment, however, it was accompanied by 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 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.
ECT treatment uses a controlled electric current delivered to the prefrontal cortex of the brain, which is typically underactivated in individuals with depression. Ultra brief stimulation refines the pulses by shortening them in a staccato rhythm, and since the pulses are so short the stimulation of brain tissue is also reduced by a third.
ECT is reserved for individuals who have not responded to first-line treatments such as medication, but the new method could potentially make the treatments less difficult on patients. The researchers hope the findings help expand the availability of ultra-brief electrical stimulation in the country and around the world.
“We are still working hard to change the broader medical profession’s and general public’s perception of ECT, which has struggled to shake off the tarnished image given to it by popular movies such as the 1975 film ‘One Flew Over the Cuckoo’s Nest’,” said Professor Loo, who is also director of ECT at Sydney’s Wesley Hospital and a researcher with the Black Dog Institute.
While the researchers believe in the benefits of ultra-brief stimulation, they conclude standard ECT should still be considered over the new treatment in situations where urgent response is needed.