La terapia elettroconvulsivante nel trattamento della depressione maggiore resistente

Introduction

The efficacy of electroconvulsive therapy (ECT) in treating depressive symptoms has been established by different studies. This paper reviews the current knowledge of ECT in the treatment of major depressive disorder and its implications in clinical practice.

Materials and methods

In this review we analyzed studies on the efficacy and safety of ECT, quality of life, and factors predictive of response. A search of the literature was conducted in PubMed using the terms “electroconvulsive therapy”, “major depressive disorder”, “efficacy”, “tolerability”, “cognitive impairment”, “meta-analysis”, “quality of life”, “predictive response factors”, “maintenance treatment”.

Results

In a high percentage of patients ECT is associated with remission of symptoms and improvement of the quality of life. Factors predicting especially good ECT responses in depressed patients include psychomotor retardation, psychosis, and advanced age. Cognitive side-effects are the main limitation of ECT although efficacy and tolerability vary according to the used ECT technique.

Conclusions

ECT is one of the most powerful treatments available. Thanks to the improvements in technique, ECT has become even safer and more useful for treatment of acute phase of depression and for the prevention of new depressive episodes.