Humanities
Skip to main content Skip to main navigation menu Skip to site footer
  • Register
  • Login
  • Menu
  • Home
  • Current
  • Archives
  • Announcements
  • About
    • About the Journal
    • Submissions
    • Editorial Team
    • Privacy Statement
    • Contact
  • Register
  • Login

Journal of Education, Health and Sport

Efficacy and Controversies Surrounding Electroconvulsive Therapy for Treatment-Resistant Depression: A Literature Review
  • Home
  • /
  • Efficacy and Controversies Surrounding Electroconvulsive Therapy for Treatment-Resistant Depression: A Literature Review
  1. Home /
  2. Archives /
  3. Vol. 67 (2024) /
  4. Health Sciences

Efficacy and Controversies Surrounding Electroconvulsive Therapy for Treatment-Resistant Depression: A Literature Review

Authors

  • Karolina Czupryńska Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0007-8932-2688
  • Karina Otręba University Clinical Centre of the Medical University of Warsaw, Żwirki i Wigury 63A, 02-091 Warszawa, Poland https://orcid.org/0009-0009-9655-5353
  • Piotr Daniel National Medical Institute of the Ministry of the Interior and Administration, Wołoska 137, 02-507 Warszawa, Poland https://orcid.org/0009-0007-3920-2645
  • Michał Leśkiewicz University Clinical Centre of the Medical University of Warsaw, Żwirki i Wigury 63A, 02-091 Warszawa, Poland https://orcid.org/0009-0000-0890-2672
  • Justyna Składanek Doctor Anna Gostyńska Wolski Hospital, Marcina Kasprzaka 17, 01-211 Warsaw, Poland https://orcid.org/0009-0003-0547-6841
  • Joanna Cieszkowska Medical University of Lublin, Aleje Racławickie 1, 20-059 Lublin https://orcid.org/0000-0002-4011-1149

DOI:

https://doi.org/10.12775/JEHS.2024.67.54495

Keywords

Electroconvulsive Therapy, Depressive Disorder, Treatment-Resistant, Mental Health, Mental Disorders

Abstract

Electroconvulsive therapy (ECT) remains a vital treatment option for individuals with treatment-resistant depression (TRD). Despite its historical stigma, controversy, and limited accessibility, ECT has been demonstrated to be beneficial and effective in severe cases of depressive disorders, where medication fails to produce results. It has been utilized since 1938 as a therapeutic technique for various psychiatric disorders, often used as an alternative to chemically induced seizures. The public’s perspectives on ECT hold significance as they can shape attitudes toward patients undergoing this therapy and the discrimination associated with receiving ECT. Additionally, the perspectives of patients who may benefit from ECT and those who are already undergoing treatment are crucial as they can influence treatment decisions and consent processes. This literature review examines the efficacy and controversies surrounding ECT in the management of TRD. Studies assessing the effectiveness of ECT in TRD, along with associated adverse effects and ethical considerations, are reviewed. Additionally, the role of ECT in contemporary psychiatric practice and its comparison with alternative treatments for TRD are discussed. The review highlights the complex interplay between clinical efficacy, safety, patient preferences, and societal perceptions in shaping the utilization of ECT in the treatment of TRD.

References

Greden JF. The burden of recurrent depression: causes, consequences, and future prospects. J Clin Psychiatry. 2001;62 Suppl 22:5-9.

Fleck MP, Horwath E. Pharmacologic management of difficult-to-treat depression in clinical practice. Psychiatr Serv. 2005;56(8):1005-1011. doi:10.1176/appi.ps.56.8.1005

Conway CR, George MS, Sackeim HA. Toward an Evidence-Based, Operational Definition of Treatment-Resistant Depression: When Enough Is Enough. JAMA Psychiatry. 2017;74(1):9–10. doi:10.1001/jamapsychiatry.2016.2586

Reutfors J, Andersson TM, Brenner P, et al. Mortality in treatment-resistant unipolar depression: A register-based cohort study in Sweden. J Affect Disord. 2018;238:674-679. doi:10.1016/j.jad.2018.06.030

Fink M. ECT has proved effective in treating depression... Nature. 2000;403(6772):826. doi:10.1038/35002776

National Institute for Health and Care Excellence . Depression in adults: treat­ment and management. www.nice.org.uk/Guidance/ng222

Milev RV, Giacobbe P, Kennedy SH, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 4. Neurostimulation Treatments. The Canadian Journal of Psychiatry. 2016;61(9):561-575. doi:10.1177/0706743716660033

Han KY, Wang CM, Du CB, Qiao J, Wang YL, Lv LZ. Treatment outcomes and cognitive function following electroconvulsive therapy in patients with severe depression. World J Psychiatry. 2023;13(11):949-957. Published 2023 Nov 19. doi:10.5498/wjp.v13.i11.949

Cerletti U, Bini L. Electroshock *†. Int Rev Psychiatry. 2018;30(2):153-154. doi:10.1080/09540261.2018.1436662

Chen JJ, Zhao LB, Liu YY, Fan SH, Xie P. Comparative efficacy and acceptability of electroconvulsive therapy versus repetitive transcranial magnetic stimulation for major depression: A systematic review and multiple-treatments meta-analysis. Behav Brain Res. 2017;320:30-36. doi:10.1016/j.bbr.2016.11.028

Soda T, McLoughlin DM, Clark SR, et al. International Consortium on the Genetics of Electroconvulsive Therapy and Severe Depressive Disorders (Gen-ECT-ic). Eur Arch Psychiatry Clin Neurosci. 2020;270(7):921-932. doi:10.1007/s00406-019-01087-w

Payne NA, Prudic J. Electroconvulsive therapy: Part II: a biopsychosocial perspective. J Psychiatr Pract. 2009;15(5):369-390. doi:10.1097/01.pra.0000361278.73092.85

Sienaert P. Based on a True Story? The Portrayal of ECT in International Movies and Television Programs. Brain Stimul. 2016;9(6):882-891. doi:10.1016/j.brs.2016.07.005

Clothier JL, Freeman T, Snow L. Medical student attitudes and knowledge about ECT. J ECT. 2001;17(2):99-101. doi:10.1097/00124509-200106000-00003

Kellner CH, Obbels J, Sienaert P. When to consider electroconvulsive therapy (ECT). Acta Psychiatr Scand. 2020;141(4):304-315. doi:10.1111/acps.13134

Bjølseth TM, Engedal K, Benth JŠ, Dybedal GS, Gaarden TL, Tanum L. Clinical efficacy of formula-based bifrontal versus right unilateral electroconvulsive therapy (ECT) in the treatment of major depression among elderly patients: a pragmatic, randomized, assessor-blinded, controlled trial. J Affect Disord. 2015;175:8-17. doi:10.1016/j.jad.2014.12.054

Dominiak M, Antosik-Wójcińska AZ, Goetz Z, et al. Efficacy, safety and tolerability of formula-based unilateral vs bilateral electroconvulsive therapy in the treatment of major depression: A randomized open label controlled trial. J Psychiatr Res. 2021;133:52-59. doi:10.1016/j.jpsychires.2020.12.002

Zielinski RJ, Roose SP, Devanand DP, Woodring S, Sackeim HA. Cardiovascular complications of ECT in depressed patients with cardiac disease. Am J Psychiatry. 1993;150(6):904-909. doi:10.1176/ajp.150.6.904

Li M, Yao X, Sun L, et al. Effects of Electroconvulsive Therapy on Depression and Its Potential Mechanism. Front Psychol. 2020;11:80. Published 2020 Feb 20. doi:10.3389/fpsyg.2020.00080

Dong M, Zhu XM, Zheng W, et al. Electroconvulsive therapy for older adult patients with major depressive disorder: a systematic review of randomized controlled trials. Psychogeriatrics. 2018;18(6):468-475. doi:10.1111/psyg.12359

Riva-Posse P, Hermida AP, McDonald WM. The role of electroconvulsive and neuromodulation therapies in the treatment of geriatric depression. Psychiatr Clin North Am. 2013;36(4):607-630. doi:10.1016/j.psc.2013.08.007

Geduldig ET, Kellner CH. Electroconvulsive Therapy in the Elderly: New Findings in Geriatric Depression. Curr Psychiatry Rep. 2016;18(4):40. doi:10.1007/s11920-016-0674-5

Singh A, Kar SK. How Electroconvulsive Therapy Works?: Understanding the Neurobiological Mechanisms. Clin Psychopharmacol Neurosci. 2017;15(3):210-221. doi:10.9758/cpn.2017.15.3.210

Segi-Nishida E. Exploration of new molecular mechanisms for antidepressant actions of electroconvulsive seizure. Biol Pharm Bull. 2011;34(7):939-944. doi:10.1248/bpb.34.939

Baldinger P, Lotan A, Frey R, Kasper S, Lerer B, Lanzenberger R. Neurotransmitters and electroconvulsive therapy. J ECT. 2014;30(2):116-121. doi:10.1097/YCT.0000000000000138

Madsen TM, Treschow A, Bengzon J, Bolwig TG, Lindvall O, Tingström A. Increased neurogenesis in a model of electroconvulsive therapy. Biol Psychiatry. 2000;47(12):1043-1049. doi:10.1016/s0006-3223(00)00228-6

Lyden H, Espinoza RT, Pirnia T, et al. Electroconvulsive therapy mediates neuroplasticity of white matter microstructure in major depression. Transl Psychiatry. 2014;4(4):e380. Published 2014 Apr 8. doi:10.1038/tp.2014.21

Machado-Vieira R, Baumann J, Wheeler-Castillo C, et al. The Timing of Antidepressant Effects: A Comparison of Diverse Pharmacological and Somatic Treatments. Pharmaceuticals (Basel). 2010;3(1):19-41. Published 2010 Jan 6. doi:10.3390/ph3010019

Weiner RD, Reti IM. Key updates in the clinical application of electroconvulsive therapy. Int Rev Psychiatry. 2017;29(2):54-62. doi:10.1080/09540261.2017.1309362

Ramasubramanian V, Mathumathi S, Rajendhiran G, Bijulakshmi P, Kannan M. A comparative study of the effect of electroconvulsive therapy and transcranial direct current stimulation in the treatment of persons suffering from treatment-resistant depression. Ind Psychiatry J. 2022;31(1):68-73. doi:10.4103/ipj.ipj_217_20

Lefaucheur JP, Antal A, Ayache SS, et al. Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS). Clin Neurophysiol. 2017;128(1):56-92. doi:10.1016/j.clinph.2016.10.087

Grimm S, Beck J, Schuepbach D, et al. Imbalance between left and right dorsolateral prefrontal cortex in major depression is linked to negative emotional judgment: an fMRI study in severe major depressive disorder. Biol Psychiatry. 2008;63(4):369-376. doi:10.1016/j.biopsych.2007.05.033

Brunoni AR, Boggio PS, De Raedt R, et al. Cognitive control therapy and transcranial direct current stimulation for depression: a randomized, double-blinded, controlled trial. J Affect Disord. 2014;162:43-49. doi:10.1016/j.jad.2014.03.026

Kalu UG, Sexton CE, Loo CK, Ebmeier KP. Transcranial direct current stimulation in the treatment of major depression: a meta-analysis. Psychol Med. 2012;42(9):1791-1800. doi:10.1017/S0033291711003059

Grunhaus L, Schreiber S, Dolberg OT, Polak D, Dannon PN. A randomized controlled comparison of electroconvulsive therapy and repetitive transcranial magnetic stimulation in severe and resistant nonpsychotic major depression. Biol Psychiatry. 2003;53(4):324-331. doi:10.1016/s0006-3223(02)01499-3

Dannon PN, Dolberg OT, Schreiber S, Grunhaus L. Three and six-month outcome following courses of either ECT or rTMS in a population of severely depressed individuals--preliminary report. Biol Psychiatry. 2002;51(8):687-690. doi:10.1016/s0006-3223(01)01274-4

Ren J, Li H, Palaniyappan L, et al. Repetitive transcranial magnetic stimulation versus electroconvulsive therapy for major depression: a systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry. 2014;51:181-189. doi:10.1016/j.pnpbp.2014.02.004

Portella MJ, Puigdemont D, Pérez-Egea R, et al. P01-84 - Deep Brain Stimulation, Electroconvulsive Therapy, or Both? A Two Case Report. European Psychiatry. 2010;25(S1):25-E303. doi:10.1016/S0924-9338(10)70303-5

Mayberg HS, Lozano AM, Voon V, et al. Deep brain stimulation for treatment-resistant depression. Neuron. 2005;45(5):651-660. doi:10.1016/j.neuron.2005.02.014

Malone DA Jr, Dougherty DD, Rezai AR, et al. Deep brain stimulation of the ventral capsule/ventral striatum for treatment-resistant depression. Biol Psychiatry. 2009;65(4):267-275. doi:10.1016/j.biopsych.2008.08.029

Zarzycki MZ, Domitrz I. Stimulation-induced side effects after deep brain stimulation – a systematic review. Acta Neuropsychiatrica. 2020;32(2):57-64. doi:10.1017/neu.2019.35

Holtzheimer PE, Mayberg HS. Deep brain stimulation for psychiatric disorders. Annu Rev Neurosci. 2011;34:289-307. doi:10.1146/annurev-neuro-061010-113638

Lambrichts S, Detraux J, Vansteelandt K, et al. Does lithium prevent relapse following successful electroconvulsive therapy for major depression? A systematic review and meta-analysis. Acta Psychiatr Scand. 2021;143(4):294-306. doi:10.1111/acps.13277

Sackeim HA, Haskett RF, Mulsant BH, et al. Continuation pharmacotherapy in the prevention of relapse following electroconvulsive therapy: a randomized controlled trial. JAMA. 2001;285(10):1299-1307. doi:10.1001/jama.285.10.1299

Prudic J, Olfson M, Marcus SC, Fuller RB, Sackeim HA. Effectiveness of electroconvulsive therapy in community settings. Biol Psychiatry. 2004;55(3):301-312. doi:10.1016/j.biopsych.2003.09.015

Sackeim HA, Prudic J, Devanand DP, Decina P, Kerr B, Malitz S. The impact of medication resistance and continuation pharmacotherapy on relapse following response to electroconvulsive therapy in major depression. J Clin Psychopharmacol. 1990;10(2):96-104. doi:10.1097/00004714-199004000-00004

Youssef NA, McCall WV. Relapse prevention after index electroconvulsive therapy in treatment-resistant depression. Ann Clin Psychiatry. 2014;26(4):288-296.

Spiker DG, Stein J, Rich CL. Delusional Depression and Electroconvulsive Therapy: One Year Later. Convuls Ther. 1985;1(3):167-172.

Aronson TA, Shukla S, Hoff A. Continuation Therapy After ECT for Delusional Depression: A Naturalistic Study of Prophylactic Treatments and Relapse. Convuls Ther. 1987;3(4):251-259.

Downloads

  • PDF

Published

2024-09-09

How to Cite

1.
CZUPRYŃSKA, Karolina, OTRĘBA, Karina, DANIEL, Piotr, LEŚKIEWICZ, Michał, SKŁADANEK, Justyna and CIESZKOWSKA, Joanna. Efficacy and Controversies Surrounding Electroconvulsive Therapy for Treatment-Resistant Depression: A Literature Review. Journal of Education, Health and Sport. Online. 9 September 2024. Vol. 67, p. 54495. [Accessed 18 May 2025]. DOI 10.12775/JEHS.2024.67.54495.
  • ISO 690
  • ACM
  • ACS
  • APA
  • ABNT
  • Chicago
  • Harvard
  • IEEE
  • MLA
  • Turabian
  • Vancouver
Download Citation
  • Endnote/Zotero/Mendeley (RIS)
  • BibTeX

Issue

Vol. 67 (2024)

Section

Health Sciences

License

Copyright (c) 2024 Karolina Czupryńska, Karina Otręba, Piotr Daniel, Michał Leśkiewicz, Justyna Składanek, Joanna Cieszkowska

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0

Stats

Number of views and downloads: 251
Number of citations: 0

Search

Search

Browse

  • Browse Author Index
  • Issue archive

User

User

Current Issue

  • Atom logo
  • RSS2 logo
  • RSS1 logo

Information

  • For Readers
  • For Authors
  • For Librarians

Newsletter

Subscribe Unsubscribe

Tags

Search using one of provided tags:

Electroconvulsive Therapy, Depressive Disorder, Treatment-Resistant, Mental Health, Mental Disorders
Up

Akademicka Platforma Czasopism

Najlepsze czasopisma naukowe i akademickie w jednym miejscu

apcz.umk.pl

Partners

  • Akademia Ignatianum w Krakowie
  • Akademickie Towarzystwo Andragogiczne
  • Fundacja Copernicus na rzecz Rozwoju Badań Naukowych
  • Instytut Historii im. Tadeusza Manteuffla Polskiej Akademii Nauk
  • Instytut Kultur Śródziemnomorskich i Orientalnych PAN
  • Instytut Tomistyczny
  • Karmelitański Instytut Duchowości w Krakowie
  • Ministerstwo Kultury i Dziedzictwa Narodowego
  • Państwowa Akademia Nauk Stosowanych w Krośnie
  • Państwowa Akademia Nauk Stosowanych we Włocławku
  • Państwowa Wyższa Szkoła Zawodowa im. Stanisława Pigonia w Krośnie
  • Polska Fundacja Przemysłu Kosmicznego
  • Polskie Towarzystwo Ekonomiczne
  • Polskie Towarzystwo Ludoznawcze
  • Towarzystwo Miłośników Torunia
  • Towarzystwo Naukowe w Toruniu
  • Uniwersytet im. Adama Mickiewicza w Poznaniu
  • Uniwersytet Komisji Edukacji Narodowej w Krakowie
  • Uniwersytet Mikołaja Kopernika
  • Uniwersytet w Białymstoku
  • Uniwersytet Warszawski
  • Wojewódzka Biblioteka Publiczna - Książnica Kopernikańska
  • Wyższe Seminarium Duchowne w Pelplinie / Wydawnictwo Diecezjalne „Bernardinum" w Pelplinie

© 2021- Nicolaus Copernicus University Accessibility statement Shop