Gentle electric shocks for depression

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MunichElectric shocks as therapy appear martial, but are still used today in the treatment of severe depression. With good reason, my experts and a new study shows: Particularly gentle brain stimulation has fewer side effects than standard electrotherapy.

Controlled epileptic seizure

Major depression is primarily treated with medication and psychotherapy. But with some people without success. Then the so-called electroconvulsive therapy or electroconvulsive therapy (ECT) is used.

In ECT, an epileptic seizure is triggered by a controlled, electric shock through electrodes on the head of the person concerned - unnoticed by the anesthetized patient. The cramps are also barely noticeable from the outside and are alleviated by a muscle-relaxing drug. Usually the stimulation lasts about 20 to 30 seconds.

Shorter shocks - fewer side effects

Researchers at the University of New South Wales compared the conventional, short ECT and a new treatment method with ultra-short stimulations for treatment success and side effects. For this purpose, Professor Colleen Loo and her team analyzed six studies with a total of 689 participants.

Breakthrough development

The result: the conventional ECT method was somewhat more effective than the new ultra-short stimulation, but it also had more side effects in all the mental areas tested. These included, for example, memory and learning problems.

“With the ultra-short ECT, the stimulation of the brain tissue was reduced by a third. They destroyed fewer memories and reduced learning difficulties. The new method is one of the most important developments in the therapy of depression in the last two decades, ”says Loo.

Cost-benefit ratio unclear

However, it is impossible to say in general which therapy is ultimately more suitable. Doctors and patients must carefully weigh effective benefits and mental harm. In cases where a rapid improvement in depression has to be achieved, the conventional ECT can still be preferred to the new method, according to the scientists.The long-term cost-benefit ratio of ultra-short stimulation still needs to be researched in the future.

Not for everyone

The ECT procedure may only be used on people who have not responded adequately to drug treatments. In addition to stable cardiovascular function, an inconspicuous computed tomographic examination of the head is a prerequisite.

Inpatient stay is worthwhile

Electroconvulsive therapy usually lasts about three weeks and includes nine to twelve applications. In most cases, an inpatient stay is necessary in order to monitor the progress of therapy and side effects.

It is unclear why the procedure has an antidepressant effect. Experts suspect that the activated nerve cells may release more messenger substances. In many cases, ECT can break through phases of depression that have lasted for months or years. (vv)

Source: Tor, P. et al. A Systematic Review and Meta-Analysis of Brief Versus Ultrabrief Right Unilateral Electroconvulsive Therapy for Depression. J Clin Psychiatry 2015. 10.4088 / JCP.14r09145.

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