Trial reportArchives of general psychiatry2006
Continuation electroconvulsive therapy vs pharmacotherapy for relapse prevention in major depression: a multisite study from the Consortium for Research in Electroconvulsive Therapy (CORE).
Trial report in Archives of general psychiatry, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 122 papers, 11 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Phase 1 Study: Evaluation of Three Continuation Therapies After Acute Electroconvusive Therapy (ECT) Concerning Efficacy and Cognition in Severly Depressed Patients
Randomised Controlled Trial of Electroconvulsive Therapy (ECT) With Pharmacotherapy or Pharmacotherapy Alone in Relapse Prevention of Depression
Prolonging Remission in Depressed Elderly (PRIDE)
Comparing Therapeutic Efficacy and Cognitive Side Effects of Electroconvulsive Therapy (ECT) Using Ketamine Versus Methohexital Anesthesia
Changing Tactics? Optimizing ECT in Difficult-to-treat Depression: A Randomized Trial Comparing Continuation of Right Unilateral ECT and Switching to Bitemporal ECT in Case of Early Non-response During an Acute Course of ECT for Difficult-to-treat Depression
Who cites it
122 citing papers in PubMed, 11 syntheses or guidelines pooled it, 467 citations in OpenAlex.
- Maintenance of Noninvasive Brain Stimulation for Preventing Relapse in Depression: A Systematic Review and Meta-Analysis.Alpha psychiatry · 2025Pooled it
- Continuation electroconvulsive therapy combined with pharmacotherapy for depression relapse prevention: A systematic review and meta-analysis.Psychological medicine · 2025Pooled it
- Systematic review: Electroconvulsive therapy for treatment-resistant mood disorders in children and adolescents.European child & adolescent psychiatry · 2023Pooled it
- Effects of Hesel-coil deep transcranial magnetic stimulation for depression - a systematic review.Nordic journal of psychiatry · 2016Pooled it
- Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 4. Neurostimulation Treatments.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2016Pooled it
- Prevention of Relapse and Recurrence in Adults with Major Depressive Disorder: Systematic Review and Meta-Analyses of Controlled Trials.The international journal of neuropsychopharmacology · 2015Pooled it
- Magnetic Seizure Therapy for Unipolar and Bipolar Depression: A Systematic Review.Neural plasticity · 2015Pooled it
- Relapse prevention after index electroconvulsive therapy in treatment-resistant depression.Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists · 2014Pooled it
- Relapse following successful electroconvulsive therapy for major depression: a meta-analysis.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2013Pooled it
- Pharmacological strategies in the prevention of relapse after electroconvulsive therapy.The journal of ECT · 2013Pooled it
- A systematic review of the combined use of electroconvulsive therapy and psychotherapy for depression.The journal of ECT · 2011Pooled it
- Durability of the benefit of vagus nerve stimulation in markedly treatment-resistant major depression: a RECOVER trial report.The international journal of neuropsychopharmacology · 2026Trial
- Extended course accelerated intermittent theta burst stimulation as a substitute for depressed patients needing electroconvulsive therapy.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2025Trial
- Longitudinal Neurocognitive Effects of Combined Electroconvulsive Therapy (ECT) and Pharmacotherapy in Major Depressive Disorder in Older Adults: Phase 2 of the PRIDE Study.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2022Trial
- Right Unilateral Ultrabrief Pulse ECT in Geriatric Depression: Phase 1 of the PRIDE Study.The American journal of psychiatry · 2016Trial
- Long-term efficacy of repeated daily prefrontal transcranial magnetic stimulation (TMS) in treatment-resistant depression.Depression and anxiety · 2012Trial
- Impact of prior pharmacotherapy on remission of psychotic depression in a randomized controlled trial.Journal of psychiatric research · 2011Trial
- Bifrontal, bitemporal and right unilateral electrode placement in ECT: randomised trial.The British journal of psychiatry : the journal of mental science · 2010Trial
- Riluzole for relapse prevention following intravenous ketamine in treatment-resistant depression: a pilot randomized, placebo-controlled continuation trial.The international journal of neuropsychopharmacology · 2010Trial
- Citalopram for continuation therapy after repetitive transcranial magnetic stimulation in vascular depression.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2009Trial
62 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
17 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundAlthough electroconvulsive therapy (ECT) has been shown to be extremely effective for the acute treatment of major depression, it has never been systematically assessed as a strategy for relapse prevention.
objectiveTo evaluate the comparative efficacy of continuation ECT (C-ECT) and the combination of lithium carbonate plus nortriptyline hydrochloride (C-Pharm) in the prevention of depressive relapse.
designMultisite, randomized, parallel design, 6-month trial performed from 1997 to 2004.
settingFive academic medical centers and their outpatient psychiatry clinics. PATIENTS: Two hundred one patients with Structured Clinical Interview for DSM-IV-diagnosed unipolar depression who had remitted with a course of bilateral ECT.
interventionsRandom assignment to 2 treatment groups receiving either C-ECT (10 treatments) or C-Pharm for 6 months.
main outcome measureRelapse of depression, compared between the C-ECT and C-Pharm groups.
resultsIn the C-ECT group, 37.1% experienced disease relapse, 46.1% continued to have disease remission at the study end, and 16.8% dropped out of the study. In the C-Pharm group, 31.6% experienced disease relapse, 46.3% continued to have disease remission, and 22.1% dropped out of the study. Both Kaplan-Meier and Cox proportional hazards regression analyses indicated no statistically significant differences in overall survival curves and time to relapse for the groups. Mean +/- SD time to relapse for the C-ECT group was 9.1 +/- 7.0 weeks compared with 6.7 +/- 4.6 weeks for the C-Pharm group (P = .13). Both groups had relapse proportions significantly lower than a historical placebo control from a similarly designed study.
conclusionsBoth C-ECT and C-Pharm were shown to be superior to a historical placebo control, but both had limited efficacy, with more than half of patients either experiencing disease relapse or dropping out of the study. Even more effective strategies for relapse prevention in mood disorders are urgently needed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.