Efficacy and adverse reactions of different stimulus dosage of modified electroconvulsive therapy for depressive episode / 中华行为医学与脑科学杂志

ABSTRACT

Objective To evaluate the antidepressant efficacy and adverse reactions of 3 different stimulus dosage of modified electroconvulsive therapy ( MECT) in patients with depressive episode. Methods 120 patients with depressive episode were randomized into low dosage group ( n=40) ,medium dosage group ( n=40) and high dosage group ( n=40) . Low dosage were 50%× age,medium dosage was 70%×age,high dosage was 80%×age . All patients received 6 treatments. Hamilton depression scale?17(HAMD?17) was used to evaluate the clinical symptoms at baseline,3 and 6 treatments. Effects and adverse reactions were compared among three groups.Results Compared with baseline the HAMD?17 scores of the 3 groups were significantly improved after 6 treatments( t=24.026, P=0.000;t=26.541, P=0.000;t=25.904, P=0.000) , but there were no statistically significant differences among the three dosage groups(F=0.409, P=0.665). Compared with low dosage group((27.2±5.4)%),the HAMD?17 scores reductive ratio of medium dosage group((34.3±6.8)%) and high dosage group((33.9±6.9)%)) were significantly improved after 3 treat?ments ( t=-5.513, P=0.000;t=-4.785, P=0.000). Compared with the low dosage group,the incidence rate of headache,nausea and vomiting,delirium were significantly higher in high dosage groups( headacheχ2=14.532, P=0.000;nausea and vomitingχ2=13.333, P=0.000;deliriumχ2=14.907, P=0.000) . The re?covery time was significantly longer in medium dosage group ( ( 10. 5 ± 1. 6 ) min ) and high dosage group ((11.2±1.8)min) than that in low dosage group((8.8±1.2)min)( t=-5.144,=0.000;t=-6.889, P=0.000).Conclusion Different stimulus dosage of MECT for depressive episode has equivalent curative effect after 6 treatment . Medium dosage and high dosage treatments appear to have an early onset of efficacy,but may also be associated with more adverse reactions.