Table 1:

Studies examining the use of electroconvulsive therapy for the treatment of major depressive disorder

Study	Study type	No. of patients; condition	Outcome
Sackeim et al. (12)	Multicentre RCT, sham control	290 patients; MDD	Decreased 6-mo relapse rates following ECT with combination of nortriptyline and lithium (39%) v. nortriptyline alone (60%) or placebo (84%)
UK ECT Review Group (10)	Meta-analysis	22 trials involving 1408 patients; MDD	Real ECT was more effective than sham ECT (difference in HRSD = 9.7, 95% CI 5.7–13.5) ECT was more effective than pharmacotherapy (difference in HRSD = 5.2, 95% CI 1.4–8.9) Bilateral ECT was more effective than unipolar ECT (difference in HRSD = 3.6, 95% CI 2.2–5.2)
Pagnin et al. (11)	Meta-analysis	13 RCTs involving 892 patients; MDD	Antidepressant response was more likely with real ECT than with sham ECT (OR 4.77, 95% CI 2.39–9.49) Antidepressant response was more likely with ECT than with medication (OR 3.72, 95% CI 2.60–5.32)
Husain et al. (13)	Multicentre, prospective, open-label	253 patients; MDD	Median time to response: 3 ECT treatments
Kellner et al. (14)	Multicentre, prospective, open-label	131 patients; MDD and expressed suicidal ideation or acts	Median time to relief of suicidal ideation: 4 ECT treatments
Kellner et al. (15)	Multicentre, parallel- design RCT	201 patients; MDD successfully treated with ECT	Continuation ECT was equally effective in preventing relapse (6-mo relapse rate 37.1%) as was combination of nortriptyline and lithium (6-mo relapse rate 31.6%)
Kellner et al. (16)	Multicentre, double-blind RCT	230 patients; MDD or bipolar disorder	Equivalent remission rates were seen with bitemporal (64%, 95% CI 53%–75%), bifrontal (61%, 95% CI 50%–71%) and high-dose right unilateral ECT (55%, 95% CI 43%–66%)

Note: CI = confidence interval, ECT = electroconvulsive therapy, HRSD = Hamilton Rating Scale for Depression, MDD = major depressive disorder, NA = not applicable, OR = odds ratio, RCT = randomized controlled trial.