BMJ 1998;316:233 (17 January)

Letters

ECT should be treatment option in all cases of refractory depression

Editor–In the ABC of Mental Health, Hale highlights the poor response of psychotic depression to antidepressants alone.1 His assertion that electroconvulsive therapy is effective only for depressed patients who are either deluded or have marked psychomotor retardation is not, however, supported by the findings of recent studies of the outcome of the treatment.

Combined results of the Northwick Park and Leicester randomised controlled trials raised the concern that electroconvulsive therapy is an effective treatment of depression only in patients with delusions or retardation.2 This pattern was not confirmed in the Nottingham trial, which found that real electroconvulsive therapy was more effective than simulated treatment in both non-retarded and non-deluded patients.3 The relation between depressive subtype and outcome was also evaluated in two randomised controlled trials in New York.4 The authors reported a 70% response rate to effective forms of electroconvulsive therapy, which was unrelated to the presence of psychosis or . . . [Full text of this article]


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Relevant Article

ABC of mental health: Depression
Anthony S Hale
BMJ 1997 315: 43-46. [Extract] [Full Text]

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