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Table 27Efficacy of ECT versus pharmacotherapy: Tier 1

Author, year
Endpoint
Current Episode Failure Requirement
Quality
Intervention and Sample Size
Study Details
Population CharacteristicsChange in Depressive SymptomsResponse
Remission
Folkerts et al., 199766
End of study phase (2-4 weeks), per protocol analysis Tier 1: Did not require failure in the current episode
Fair
ECT (n = 21*)
Right unilateral, mean txts = 7.2 sessions (2-3 weeks)
Pharmacotherapy (n = 18*)
Paroxetine 40 mg (max 50 mg/d, mean 44 mg/day)
*per protocol
Treatment Strategy
Switch
Diagnosis
Bipolar (%)
ECT: 9.5
Pharm: 16.7
Mean number of failed antidepressant trials:
ECT: 4.9
Pharm: 4.3
Baseline Depression
HAM-D21, mean (SD)
ECT: 31.1 (4.9)
Pharm: 32.6 (5.4)
HAM-D21
Change, mean (SD)
ECT: -18.6
Pharm: -9.6
P = 0.001
HAM-D21
Response, n (%)
ECT: 15 (71.4)
Pharm: 5 (27.8)
P = 0.006

ECT = electroconvulsive therapy; ; HAM-D21 = 21-item Hamilton Depression Scale; max = maximum, mg = milligram; mg/d = milligram per day; n = number; P = p-value; pharm = pharmacotherapy; SD = standard deviation; txt(s) = treatment(s)

From: Results

Cover of Nonpharmacologic Interventions for Treatment-Resistant Depression in Adults
Nonpharmacologic Interventions for Treatment-Resistant Depression in Adults [Internet].
Comparative Effectiveness Reviews, No. 33.
Gaynes BN, Lux LJ, Lloyd SW, et al.

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