Evidence map›Paper›PMID 32585354›Full record

Trial reportBrain stimulation

The benefits and costs of changing treatment technique in electroconvulsive therapy due to insufficient improvement of a major depressive episode.

Harold A Sackeim, Joan Prudic, D P Devanand, Mitchell S Nobler, Roger F Haskett, Benoit H Mulsant, Peter B Rosenquist, William V McCall

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Brain stimulation. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05923801 (Changing Tactics? Optimizing ECT in Difficult-to-treat Depression), which is not on this map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.7field-weighted citation impact, top 16% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT05923801 narecruitingnot on this map

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

TypeinterventionalSponsorUniversitaire Ziekenhuizen KU LeuvenRan2023 to 2026Enrolled196ConditionsDepressionArmsswitch to BT electrode position, continue with RUL electrode position
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 23 citations in OpenAlex.

  1. Trial
  2. Review
  3. Review
  4. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 2 countries.

Harold A SackeimDepartment of Psychiatry, Columbia University, NY, USA; Department of Radiology, Columbia University, NY, USA. Electronic address: has1@columbia.edu.
Joan PrudicDepartment of Psychiatry, Columbia University, NY, USA; New York State Psychiatric Institute, NY, USA.
D P DevanandDepartment of Psychiatry, Columbia University, NY, USA; New York State Psychiatric Institute, NY, USA; Department of Neurology, Columbia University, NY, USA.
Mitchell S NoblerDepartment of Psychiatry & Behavioral Sciences, New York Medical College, NY, USA.
Roger F HaskettDepartment of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
Benoit H MulsantDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada.
Peter B RosenquistDepartment of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA, USA.
William V McCallDepartment of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA, USA.
Augusta University · USNew York Psychoanalytic Society and Institute · USCentre for Addiction and Mental Health · CAColumbia University · USNew York Medical College · USUniversity of Pittsburgh · US

Funding

AFFECTIVE AND COGNITIVE CONSEQUENCES OF ECTR01MH035636 · NIMH · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · PI SACKEIM, HAROLD A. · 1985 to 2006
$2.4M
OPTIMIZATION OF ELECTROCONVULSIVE THERAPYR01MH061621 · NIMH · WASHINGTON UNIVERSITY · PI ISENBERG, KEITH E · 2001 to 2005
$1.6M
OPTIMIZATION OF ELECTROCONVULSIVE THERAPYR01MH061591 · NIMH · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI HASKETT, ROGER FRANK · 2001 to 2005
$1.5M
OPTIMIZATION OF ELECTROCONVULSIVE THERAPYR01MH061594 · NIMH · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI MCCALL, WILLIAM VAUGHN · 2001 to 2005
$1.1M
OPTIMIZATION OF ELECTROCONVULSIVE THERAPYR01MH061609 · NIMH · NEW YORK STATE PSYCHIATRIC INSTITUTE · PI SACKEIM, HAROLD A. · 2001 to 2005
$1.1M
CIHRNIMH NIH HHS R01 MH035636NIMH NIH HHS R01 MH061591NIMH NIH HHS R01 MH061594NIMH NIH HHS R01 MH061609NIMH NIH HHS R01 MH061621
6 · The paper itself

Abstract

backgroundElectroconvulsive therapy (ECT) technique is often changed after insufficient improvement, yet there has been little research on switching strategies.

objectiveTo document clinical outcome in ECT nonresponders who were received a second course using high dose, brief pulse, bifrontotemporal (HD BP BL) ECT, and compare relapse rates and cognitive effects relative to patients who received only one ECT course and as a function of the type of ECT first received.

methodsPatients were classified as receiving Weak, Strong, or HD BP BL ECT during three randomized trials at Columbia University. Nonresponders received HD BP BL ECT. In a separate multi-site trial, Optimization of ECT, patients were randomized to right unilateral or BL ECT and nonresponders also received further treatment with HD BP BL ECT.

resultsRemission rates with a second course of HD BP BL ECT were high in ECT nonresponders, approximately 60% and 40% in the Columbia University and Optimization of ECT studies, respectively. Clinical outcome was independent of the type of ECT first received. A second course with HD BP BL ECT resulted in greater retrograde amnesia immediately, two months, and six months following ECT.

conclusionsIn the largest samples of ECT nonresponders studied to date, a second course of ECT had marked antidepressant effects. Since the therapeutic effects were independent of the technique first administered, it is possible that many patients may benefit simply from longer courses of ECT. Randomized trials are needed to determine whether, when, and how to change treatment technique in ECT.

Indexed as

AdultAgedAntidepressive AgentsCost-Benefit AnalysisElectroconvulsive TherapyFemaleFollow-Up StudiesHumansMajor Depressive DisorderMaleMiddle AgedRecurrenceTreatment OutcomeAntidepressive AgentsElectroconvulsive therapy (ECT)RelapseRetrograde amnesiaSwitching strategy

Identifiers

PMID32585354
PMCPMC7494636
OpenAlexW3037118634

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.