Combining anti-depressants with electro-convulsive therapy (ECT) helps better for reducing severe depression and causes less memory loss than using ECT alone.
This finding can ease one of the primary concerns about ECT - that it causes memory loss, said W. Vaughn McCall, professor at Wake Forest University (WFU) and principal study investigator.
ECT uses the electrical stimulus to the brain to induce seizures. It is prescribed for patients with crisis-level severe depression - who are catatonic (people who are so slowed down that they stop moving, talking and eating) or suicidal - or for patients with major depression who have not responded to medication.
Electrodes attached to the head deliver the stimulus and patients are anesthetized and receive muscle relaxants during the procedure. Patients receiving ECT often experience some memory loss that usually improves within days of treatment.
Researchers wanted to find a way to increase the effectiveness of ECT while reducing the side effects of memory loss.
"Although ECT remains a powerful treatment, there is still a significant proportion of patients that do not respond - recent statistics show a 70 to 80 percent response rate," McCall said.
"Even in patients who do respond, there still is a significant risk of relapse. Patients may become ill again with depression within a matter of weeks to a few months after ECT."
After consenting to the treatment, 319 patients received either a placebo or one of two anti-depressants: nortriptyline, an older, generic drug, or venlafaxine, a newer drug that is sold under the brand name EffexorTM.
The patients also received at least one form of ECT - either bilateral, stimulating both sides of the brain, or unilateral, affecting only the right side to keep the stimulus away from the verbal learning centers in the left side of the brain.
Researchers found that using either anti-depressant during ECT improved depression more than ECT alone.
The study appeared in the current issue of the Archives of General Psychiatry.
