SynthesisActa psychiatrica Scandinavica2022
Pharmacological interventions to diminish cognitive side effects of electroconvulsive therapy: A systematic review and meta-analysis.
Synthesis in Acta psychiatrica Scandinavica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Efficacy and safety of ketamine-assisted electroconvulsive therapy in major depressive episode: a systematic review and network meta-analysis.Molecular psychiatry · 2024Pooled it
- Pharmacological interventions to diminish cognitive side effects of electroconvulsive therapy: A systematic review and meta-analysis.Acta psychiatrica Scandinavica · 2022Pooled it
- Trial
- Microbiome-Informed Precision Electroconvulsive Therapy: Oral-Gut-Immune Signatures and Seizure Biology as Candidate Predictors of Response-A Narrative Review.Biomedicines · 2026Review
- The postictal systems window hypothesis of electroconvulsive therapy in major depression.Frontiers in psychiatry · 2026Article
- Bipolar disorders: an update on critical aspects.The Lancet regional health. Europe · 2025Review
- Article
- How electroconvulsive therapy works in the treatment of depression: is it the seizure, the electricity, or both?Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2024Review
- Recent advances in electroconvulsive therapy in clinical practice and research.Faculty reviews · 2023Review
- Medication preventing postictal hypoperfusion and cognitive side-effects in electroconvulsive therapy: A retrospective cohort study.Frontiers in psychiatry · 2023Article
- Melatonin as a Neuroprotective Adjunct in Bipolar Patients Undergoing Electroconvulsive Therapy: A Double-blind Randomized Controlled Trial.Basic and clinical neuroscienceArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe authors conducted a systematic review and meta-analysis of pharmacological interventions to diminish cognitive side effects of ECT.
methodsElectronic databases of Pubmed, PsycInfo, Embase and Scopus were searched from inception through 1 April, 2021, using terms for ECT (e.g. electroconvulsive therapy), cognitive outcome (e.g. cogni*) and pharmacological intervention (e.g. calcium channel blocker and general terms, like protein). Original studies with humans receiving ECT were included, which applied pharmacological interventions in comparison with placebo or no additive intervention to diminish cognitive side effects. Data quality was assessed using Risk of Bias and GRADE. Random-effects models were used. PROSPERO registration number was CRD42021212773.
resultsQualitative synthesis (systematic review) showed 52 studies reporting sixteen pharmacological intervention-types. Quantitative synthesis (meta-analysis) included 26 studies (1387 patients) describing twelve pharmacological intervention-types. Low-quality evidence of efficacy was established for memantine (large effect size) and liothyronine (medium effect size). Very low-quality evidence shows effect of acetylcholine inhibitors, piracetam and melatonin in some cognitive domains. Evidence of no efficacy was revealed for ketamine (very low-quality), herbal preparations with anti-inflammatory properties (very low to low-quality) and opioid receptor agonists (low-quality).
conclusionMemantine and liothyronine are promising for further research and future application. Quality of evidence was low because of differences in ECT techniques, study populations and cognitive measurements. These findings provide a guide for rational choices of potential pharmacological intervention research targets to decrease the burden of cognitive side effects of ECT. Future research should be more uniform in design and attempt to clarify pathophysiological mechanisms of cognitive side effects of ECT.
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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.