Authors' recommendations: No studies on the clinical effectiveness and safety of performing electroconvulsive therapy (ECT) outside of a surgical suite for patients with depression were identified. Three systematic reviews were identified comparing ECT with repetitive transcranial magnetic stimulation (rTMS). One found greater improvement in depressive symptoms with ECT but did not report statistical significance. One SR showed that response and remission were statistically significantly better with ECT. One SR presented results for separate groups of studies according to extent of previous treatment failure. Results for depressive severity, response, remission and cognitive functioning in the studies included in this SR appeared to be inconsistent; some studies showed that ECT was statistically significantly better with respect to reducing depressive severity, and achieving response and remission and worse with respect to cognitive functioning whereas some studies showed there were no statistically significant differences between the two treatment modalities for these outcomes. One RCT comparing ECT with cognitive behavioural therapy (CBT) as continuation therapy after ECT treatment at the acute phase found that sustained response rates were significantly lower with ECT compared with CBT and that the cognitive side effects were not significantly different between the two.One RCT found were no significant differences between ECT and magnetic seizure therapy in responses, measured using various scales. One RCT found that recall of memorized words were statistically significantly worse with ECT compared to MST, on the treatment day but not on a day when there was no treatment while another found no statistically significant difference between the two modalities. One guideline, though not specifically on conduct of ECT outside of a surgical suite, provided some general guidance regarding a treatment site that would be conducive for ECT.

Project Status: Completed

Year Published: 2015

URL for published report: http://www.cadth.ca/sites/default/files/pdf/htis/jan-2015/RC0623-ECT-depression-Final.pdf

English language abstract: An English language summary is available

Publication Type: Rapid Review

Country: Canada

Organisation Name: Canadian Agency for Drugs and Technologies in Health

Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;

Contact Name: requests@cadth.ca

Contact Email: requests@cadth.ca

Copyright: Canadian Agency for Drugs and Technologies in Health (CADTH)