Published on January 18, 2009
Medication Resistance and ECT. Is there a problem? by Walter van den Broek
The indication for ECT has changed: Medication Resistant Depression.
Should you worry about that?
You’re concerned about medication resistance and response to ECT p =0.004 p <0.05 Prudic, J et al. Journal of Psychiatric Research 1990
This didn’t help to resolve your concern Prudic, J. et al. Am J Psychiatry, 1996 ATHF<3, n=18 ATHF 3 or more, n=36 Response 94% 64%
Medication resistance according to the ATHF does not influence remission and response to subsequent ECT
van den Broek, et al, Journal of Clin Psychopharmacology 2004
Co variables and their fate
Characteristics of the treatment TCA Lithium MAO ECT
Medication resistance with TCA and lithium does not influence remission and response to subsequent ECT
SSRIs are less efficacious than TCAs with depressed inpatients
Comparison of imipramine and lithium addition or fluvoxamine and lithium addition
ECT after Lithium addition Journal of Clin Psychiatry in press
Others haven’t found an influence of ATHF medication resistance on response to subsequent ECT
Real World Patients?
Husain et al, Journal of Affective Disorders, 2004.
p =0.004 p <0.05 Prudic, J et al. Journal of Psychiatric Research 1990
Prudic, J. et al. Am J Psychiatry, 1996 ATHF<3, n=18 ATHF 3 or more, n=36 Response 94% 64%
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