Ultrabrief Pulsewidth Electroconvulsive Therapy (ECT)

Summary

Electroconvulsive Therapy (ECT) remains essential to contemporary psychiatric practice and is one of the safest and most effective treatments available for depression. Despite modern advances in pharmacotherapy, about 15-20 per cent of all hospitalised patients receive treatment with ECT. Its use, however, is limited by concerns over associated cognitive side effects.

Recent research has suggested that using an ultrabrief pulsewidth with ECT may greatly reduce cognitive side effects, while maintaining efficacy (Sackeim et al 2008). Preliminary results were positive for unilateral ECT, however, suggest that for bilateral ECT, dosing may need to be adjusted to preserve efficacy while reducing side effects. This study will examine the relative cognitive side effects and efficacy of right unilateral and bilateral ECT given with a standard pulsewidth or an ultrabrief pulsewidth. Some participants will also receive an MRI scan before and after ECT.

Conditions

• Major Depressive Disorder

Interventions

PROCEDURE

bilateral ultrabrief ECT

Bilateral ECT at 3-4 times seizure threshold with an ultrabrief pulse (0.3ms)

PROCEDURE

bilateral standard ECT

Bilateral ECT with at 1.5 times seizure threshold with a standard pulse (1.0ms)

PROCEDURE

right-unilateral ultrabrief ECT

Right-unilateral ECT at 6 times seizure threshold with an ultrabrief pulse (0.3ms)

PROCEDURE

right-unilateral standard ECT

Right-unilateral ECT with at 5 times seizure threshold with a standard pulse (1.0ms)

Sponsors & Collaborators

• Northside Clinic, Australia

  collaborator OTHER

• The Melbourne Clinic, Australia

  collaborator UNKNOWN

• St George Hospital, Australia

  collaborator OTHER

• Wandene Private Hospital, Australia

  collaborator UNKNOWN

• The University of New South Wales

  lead OTHER

Principal Investigators

• Assoc/Prof Colleen K Loo, MBBS, FRANZCP, MD · University of New South Wales

• Prof Isaac Schweitzer, MBBS, FRANZCP, MD · The Melbourne Clinic

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2009-01-31

Primary Completion

2013-01-31

Completion

2013-01-31

Countries

• Australia

Study Locations