Trial Outcomes & Findings for Preventing Relapse After Successful Electroconvulsive Therapy for Depression (NCT NCT06751875)

NCT ID: NCT06751875

Last Updated: 2026-05-05

Results Overview

The investigators will compare the lithium-arm with the arm without lithium, as we look at the relapse rate and depression severity. Relapse rate was described as the percentage of patients in each of the two treatment arms that relapsed. Depression severity was measured using the Inventory of Depressive Symptomatology - Clinician Rated (IDS-C), a 30-item clinician-rated scale assessing the severity of depressive symptoms. Because only one of two 'appetite disturbance/body weight disturbance' items are selected for rating, the score of 28 items is added to reach a final score. Each item is scored 0-3, resulting in a total score range of 0-84, where higher scores indicate more severe depression.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

96 participants

Primary outcome timeframe

Start of Maintenance Phase with repeated assessments at fixed points for six months (1 month, 2 month, 3 month, 4 month, 5 month, and 6 month) during the maintenance period through 6-month follow-up.

Results posted on

2026-05-05

Participant Flow

Ninety-six patients (63.9%) entered the Maintenance Phase of the study and were randomized to either the lithium (n=50) or non-lithium (n=46) group. During the Follow-up Phase, 60 patients were followed, and 50 completed the full trial. Patients were recruited across the four sites: UPC Duffel (n=37, 38.5%), UPC KU Leuven (n=27, 28.1%), AZ Sint-Brugge (n=23, 24%) and Erasmus MC Rotterdam (n=9, 9.4%).

Participant milestones

Participant milestones
Measure
Lithium Arm
STABLE-M-ECT + M-Pharm, with lithium augmentation.
Non-Lithium Arm
STABLE-M-ECT + M-Pharm, without lithium augmentation.
Overall Study
STARTED
50
46
Overall Study
COMPLETED
26
24
Overall Study
NOT COMPLETED
24
22

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Lithium Arm
n=50 Participants
STABLE-M-ECT + M-Pharm, with lithium augmentation.
Non-Lithium Arm
n=46 Participants
STABLE-M-ECT + M-Pharm, without lithium augmentation.
Total
n=96 Participants
Total of all reporting groups
Sex: Female, Male
Male
20 Participants
n=50 Participants
16 Participants
n=46 Participants
36 Participants
n=96 Participants
Number of depressive episodes in history
2.3 Episodes
STANDARD_DEVIATION 2 • n=50 Participants
2 Episodes
STANDARD_DEVIATION 2.1 • n=46 Participants
2.2 Episodes
STANDARD_DEVIATION 2 • n=96 Participants
Age, Continuous
57.9 Years
STANDARD_DEVIATION 12.2 • n=50 Participants
61.6 Years
STANDARD_DEVIATION 13.2 • n=46 Participants
59.8 Years
STANDARD_DEVIATION 12.8 • n=96 Participants
Sex: Female, Male
Female
30 Participants
n=50 Participants
30 Participants
n=46 Participants
60 Participants
n=96 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.

PRIMARY outcome

Timeframe: Start of Maintenance Phase with repeated assessments at fixed points for six months (1 month, 2 month, 3 month, 4 month, 5 month, and 6 month) during the maintenance period through 6-month follow-up.

The investigators will compare the lithium-arm with the arm without lithium, as we look at the relapse rate and depression severity. Relapse rate was described as the percentage of patients in each of the two treatment arms that relapsed. Depression severity was measured using the Inventory of Depressive Symptomatology - Clinician Rated (IDS-C), a 30-item clinician-rated scale assessing the severity of depressive symptoms. Because only one of two 'appetite disturbance/body weight disturbance' items are selected for rating, the score of 28 items is added to reach a final score. Each item is scored 0-3, resulting in a total score range of 0-84, where higher scores indicate more severe depression.

Outcome measures

Outcome measures
Measure
Lithium Arm
n=50 Participants
STABLE-M-ECT + M-Pharm, with lithium augmentation.
Non-Lithium Arm
n=46 Participants
STABLE-M-ECT + M-Pharm, without lithium augmentation.
Relapse Rate
7 Participants
9 Participants

SECONDARY outcome

Timeframe: Five monthly assessments at 2, 3, 4, 5, and 6 months during the Maintenance Phase (modeled as one value).

Population: All participants with IDS-C ≥ 29 at baseline, from both the lithium and non-lithium arm, who completed at least one follow-up assessment were included.

Depression severity was measured using two scales: the Inventory of Depressive Symptomatology - Clinician Rated (IDS-C), a 30-item clinician-rated scale assessing the severity of depressive symptoms and the Inventory of Depressive Symptomatology - Self Rated (IDS-SR), a 30-item self-report version assessing the same depressive symptoms from the participant's perspective. Because only one of two 'appetite disturbance/body weight disturbance' items are selected for rating, the score of 28 items is added to reach a final score. Each item is scored 0-3, resulting in a total score range of 0-84, where higher scores indicate more severe depression. These total scores were subsequently used as variables in a mixed-effects model to examine changes in depression severity over time and to compare clinician-rated and self-rated assessments. All timepoints were modeled simultaneously, allowing estimation of their joint effects into one single value rather than analyzing each timepoint separately.

Outcome measures

Outcome measures
Measure
Lithium Arm
n=50 Participants
STABLE-M-ECT + M-Pharm, with lithium augmentation.
Non-Lithium Arm
n=46 Participants
STABLE-M-ECT + M-Pharm, without lithium augmentation.
Depression Severity Differences
42.7 IDS-C depression severity score
Standard Deviation 8.2
41.3 IDS-C depression severity score
Standard Deviation 9.4

SECONDARY outcome

Timeframe: Start of Maintenance Phase, timepoint at month 1.

The investigators will compare the lithium arm with the arm without lithium to evaluate neurocognitive function, as measured by the Montreal Cognitive Assessment (MoCA), which assesses multiple cognitive domains including memory, attention, executive function, language, visuospatial skills, and orientation. Standard MoCA cut-off scores will be used to interpret cognitive impairment. Cut-off scores are 26 or above (out of 30)=normal, 18-25=Mild Cognitive Impairment, 10-17=Moderate Cognitive Impairment \& Below 10=Severe Cognitive Impairment.

Outcome measures

Outcome measures
Measure
Lithium Arm
n=50 Participants
STABLE-M-ECT + M-Pharm, with lithium augmentation.
Non-Lithium Arm
n=46 Participants
STABLE-M-ECT + M-Pharm, without lithium augmentation.
Cognitive Performance
23.8 Score on a scale
Standard Deviation 3.2
23.1 Score on a scale
Standard Deviation 3.5

Adverse Events

Lithium Arm

Serious events: 0 serious events
Other events: 14 other events
Deaths: 0 deaths

Non-Lithium Arm

Serious events: 2 serious events
Other events: 13 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Lithium Arm
n=50 participants at risk
STABLE-M-ECT + M-Pharm, with lithium augmentation.
Non-Lithium Arm
n=46 participants at risk
STABLE-M-ECT + M-Pharm, without lithium augmentation.
Cardiac disorders
cardial arrythmia, needing hospitalisation
0.00%
0/50 • From enrollment until end of follow-up, up to 1 month after last test visit.
AE: any undesirable experience occurring to a subject during the study, whether or not considered related to treatment with antidepressants, ECT or Lithium. All adverse events reported spontaneously by the subject or observed by one of the investigators will be recorded SAE: any medical occurrence or effect that results in death; is life threatening; requires hospitalisation; results in persistent or significant disability or incapacity.
2.2%
1/46 • From enrollment until end of follow-up, up to 1 month after last test visit.
AE: any undesirable experience occurring to a subject during the study, whether or not considered related to treatment with antidepressants, ECT or Lithium. All adverse events reported spontaneously by the subject or observed by one of the investigators will be recorded SAE: any medical occurrence or effect that results in death; is life threatening; requires hospitalisation; results in persistent or significant disability or incapacity.
Psychiatric disorders
suicide attempt during study follow-up
0.00%
0/50 • From enrollment until end of follow-up, up to 1 month after last test visit.
AE: any undesirable experience occurring to a subject during the study, whether or not considered related to treatment with antidepressants, ECT or Lithium. All adverse events reported spontaneously by the subject or observed by one of the investigators will be recorded SAE: any medical occurrence or effect that results in death; is life threatening; requires hospitalisation; results in persistent or significant disability or incapacity.
2.2%
1/46 • From enrollment until end of follow-up, up to 1 month after last test visit.
AE: any undesirable experience occurring to a subject during the study, whether or not considered related to treatment with antidepressants, ECT or Lithium. All adverse events reported spontaneously by the subject or observed by one of the investigators will be recorded SAE: any medical occurrence or effect that results in death; is life threatening; requires hospitalisation; results in persistent or significant disability or incapacity.

Other adverse events

Other adverse events
Measure
Lithium Arm
n=50 participants at risk
STABLE-M-ECT + M-Pharm, with lithium augmentation.
Non-Lithium Arm
n=46 participants at risk
STABLE-M-ECT + M-Pharm, without lithium augmentation.
Nervous system disorders
memory complaints
10.0%
5/50 • From enrollment until end of follow-up, up to 1 month after last test visit.
AE: any undesirable experience occurring to a subject during the study, whether or not considered related to treatment with antidepressants, ECT or Lithium. All adverse events reported spontaneously by the subject or observed by one of the investigators will be recorded SAE: any medical occurrence or effect that results in death; is life threatening; requires hospitalisation; results in persistent or significant disability or incapacity.
8.7%
4/46 • From enrollment until end of follow-up, up to 1 month after last test visit.
AE: any undesirable experience occurring to a subject during the study, whether or not considered related to treatment with antidepressants, ECT or Lithium. All adverse events reported spontaneously by the subject or observed by one of the investigators will be recorded SAE: any medical occurrence or effect that results in death; is life threatening; requires hospitalisation; results in persistent or significant disability or incapacity.
Nervous system disorders
tremor to both hands
6.0%
3/50 • From enrollment until end of follow-up, up to 1 month after last test visit.
AE: any undesirable experience occurring to a subject during the study, whether or not considered related to treatment with antidepressants, ECT or Lithium. All adverse events reported spontaneously by the subject or observed by one of the investigators will be recorded SAE: any medical occurrence or effect that results in death; is life threatening; requires hospitalisation; results in persistent or significant disability or incapacity.
4.3%
2/46 • From enrollment until end of follow-up, up to 1 month after last test visit.
AE: any undesirable experience occurring to a subject during the study, whether or not considered related to treatment with antidepressants, ECT or Lithium. All adverse events reported spontaneously by the subject or observed by one of the investigators will be recorded SAE: any medical occurrence or effect that results in death; is life threatening; requires hospitalisation; results in persistent or significant disability or incapacity.
Nervous system disorders
headache
4.0%
2/50 • From enrollment until end of follow-up, up to 1 month after last test visit.
AE: any undesirable experience occurring to a subject during the study, whether or not considered related to treatment with antidepressants, ECT or Lithium. All adverse events reported spontaneously by the subject or observed by one of the investigators will be recorded SAE: any medical occurrence or effect that results in death; is life threatening; requires hospitalisation; results in persistent or significant disability or incapacity.
4.3%
2/46 • From enrollment until end of follow-up, up to 1 month after last test visit.
AE: any undesirable experience occurring to a subject during the study, whether or not considered related to treatment with antidepressants, ECT or Lithium. All adverse events reported spontaneously by the subject or observed by one of the investigators will be recorded SAE: any medical occurrence or effect that results in death; is life threatening; requires hospitalisation; results in persistent or significant disability or incapacity.
Cardiac disorders
elevation of blood pressure
0.00%
0/50 • From enrollment until end of follow-up, up to 1 month after last test visit.
AE: any undesirable experience occurring to a subject during the study, whether or not considered related to treatment with antidepressants, ECT or Lithium. All adverse events reported spontaneously by the subject or observed by one of the investigators will be recorded SAE: any medical occurrence or effect that results in death; is life threatening; requires hospitalisation; results in persistent or significant disability or incapacity.
6.5%
3/46 • From enrollment until end of follow-up, up to 1 month after last test visit.
AE: any undesirable experience occurring to a subject during the study, whether or not considered related to treatment with antidepressants, ECT or Lithium. All adverse events reported spontaneously by the subject or observed by one of the investigators will be recorded SAE: any medical occurrence or effect that results in death; is life threatening; requires hospitalisation; results in persistent or significant disability or incapacity.
Infections and infestations
COVID infection
6.0%
3/50 • From enrollment until end of follow-up, up to 1 month after last test visit.
AE: any undesirable experience occurring to a subject during the study, whether or not considered related to treatment with antidepressants, ECT or Lithium. All adverse events reported spontaneously by the subject or observed by one of the investigators will be recorded SAE: any medical occurrence or effect that results in death; is life threatening; requires hospitalisation; results in persistent or significant disability or incapacity.
4.3%
2/46 • From enrollment until end of follow-up, up to 1 month after last test visit.
AE: any undesirable experience occurring to a subject during the study, whether or not considered related to treatment with antidepressants, ECT or Lithium. All adverse events reported spontaneously by the subject or observed by one of the investigators will be recorded SAE: any medical occurrence or effect that results in death; is life threatening; requires hospitalisation; results in persistent or significant disability or incapacity.
Renal and urinary disorders
renal hypofunction
2.0%
1/50 • From enrollment until end of follow-up, up to 1 month after last test visit.
AE: any undesirable experience occurring to a subject during the study, whether or not considered related to treatment with antidepressants, ECT or Lithium. All adverse events reported spontaneously by the subject or observed by one of the investigators will be recorded SAE: any medical occurrence or effect that results in death; is life threatening; requires hospitalisation; results in persistent or significant disability or incapacity.
0.00%
0/46 • From enrollment until end of follow-up, up to 1 month after last test visit.
AE: any undesirable experience occurring to a subject during the study, whether or not considered related to treatment with antidepressants, ECT or Lithium. All adverse events reported spontaneously by the subject or observed by one of the investigators will be recorded SAE: any medical occurrence or effect that results in death; is life threatening; requires hospitalisation; results in persistent or significant disability or incapacity.

Additional Information

Didier Schrijvers

University of Antwerp

Phone: +32 (0)15/30.40.34

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place