SynthesisThe journal of ECT2013
Pharmacological strategies in the prevention of relapse after electroconvulsive therapy.
Synthesis in The journal of ECT, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.
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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.
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 104 citations in OpenAlex.
- Optimally combining transcranial magnetic stimulation with antidepressants in major depressive disorder: A systematic review and Meta-analysis.Journal of affective disorders · 2024Pooled 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
- Relapse following successful electroconvulsive therapy for major depression: a meta-analysis.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2013Pooled it
- Influence of adjuvant nortriptyline on the efficacy of electroconvulsive therapy: A randomized controlled trial and 1-year follow-up.Acta psychiatrica Scandinavica · 2022Trial
- Cognitive training to improve memory in individuals undergoing electroconvulsive therapy: Negative findings.Journal of psychiatric research · 2017Trial
- The benefits and costs of changing treatment technique in electroconvulsive therapy due to insufficient improvement of a major depressive episode.Brain stimulationTrial
- The Impact of Clinical Characteristics of Patients with Mental Disorders on the Long-Term Effects of Electroconvulsive Therapy.Journal of clinical medicine · 2026Article
- Preventing relapse in patients with major depressive disorder after an effective acute course of electroconvulsive therapy.Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists · 2026Review
- Real-world analysis of pharmacological treatments to prevent relapse after electroconvulsive therapy for major depressive disorder: A nationwide cohort study.Translational psychiatry · 2025Article
- Biological factors influencing depression in later life: role of aging processes and treatment implications.Translational psychiatry · 2023Review
- Clinical research challenges posed by difficult-to-treat depression.Psychological medicine · 2022Review
- Glutamatergic System in Depression and Its Role in Neuromodulatory Techniques Optimization.Frontiers in psychiatry · 2022Review
- Factors causing a relapse of major depressive disorders following successful electroconvulsive therapy: A retrospective cohort study.World journal of psychiatry · 2021Article
- Article
- The Efficacy and Safety of Neuromodulation Treatments in Late-Life Depression.Current treatment options in psychiatry · 2020Article
- Precision non-implantable neuromodulation therapies: a perspective for the depressed brain.Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999) · 2020Article
- The Efficacy and Safety of Concomitant Psychotropic Medication and Electroconvulsive Therapy (ECT).CNS drugs · 2020Review
- The Long and Winding Road of Vagus Nerve Stimulation: Challenges in Developing an Intervention for Difficult-to-Treat Mood Disorders.Neuropsychiatric disease and treatment · 2020Review
- Shared preventive factors associated with relapse after a response to electroconvulsive therapy in four major psychiatric disorders.Psychiatry and clinical neurosciences · 2019Article
- Lithium for suicide and readmission prevention after electroconvulsive therapy for unipolar depression: population-based register study.BJPsych open · 2019Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveTo determine whether starting antidepressant medication at the start of electroconvulsive therapy (ECT) reduces post-ECT relapse and to determine whether continuation pharmacotherapy with nortriptyline (NT) and lithium (Li) differs in efficacy or adverse effects from continuation pharmacotherapy with venlafaxine (VEN) and Li.
methodsDuring an acute ECT phase, 319 patients were randomized to treatment with moderate dosage bilateral ECT or high-dosage right unilateral ECT. They were also randomized to concurrent treatment with placebo, NT, or VEN. Of 181 patients to meet post-ECT remission criteria, 122 (67.4%) participated in a second continuation pharmacotherapy phase. Patients earlier randomized to NT or VEN continued on the antidepressant, whereas patients earlier randomized to placebo were now randomized to NT or VEN. Lithium was added for all patients who were followed until relapse or 6 months.
resultsStarting an antidepressant medication at the beginning of the ECT course did not affect the rate or timing of relapse relative to starting pharmacotherapy after ECT completion. The combination of NT and Li did not differ from VEN and Li in any relapse or adverse effect measure. Older age was strongly associated with lower relapse risk, whereas the type of ECT administered in the acute phase and medication resistance were not predictive. Across sites, 50% of the patients relapsed, 33.6% continued in remission 6 months after ECT, and 16.4% dropped out.
conclusionsStarting an antidepressant medication during ECT does not affect relapse, and there are concerns about administering Li during an acute ECT course. Nortriptyline and VEN were equally effective in prolonging remission, although relapse rates after ECT are substantial despite intensive pharmacology. As opposed to the usual abrupt cessation of ECT, the impact of an ECT taper should be evaluated.
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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.