McCall W Vaughn, Dunn Aaron, Rosenquist Peter B, Hughes Doreen
Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine,Winston-Salem, North Carolina27127, USA.
J ECT. 2002 Sep;18(3):126-9. doi: 10.1097/00124509-200209000-00003.
Right unilateral (RUL) ECT is reported to have fewer memory side effects than bilateral (BL) ECT. We compared RUL ECT at eight times the seizure threshold (ST) against BL ECT at 1.5 times the ST. Adults with major depression were randomly assigned to RUL ECT at eight times ST or BL ECT at 1.5 times the ST. Blinded ratings of mood and memory were made before ECT, 1 to 3 days after the final ECT, and at 2 and 4 weeks after ECT. Forty patients received RUL and 37 received BL ECT. The antidepressant response rate was not significantly different for the RUL and BL groups (60% vs. 73%). Sustained antidepressant response, accompanied by recovery from anterograde memory side effects, was seen through the first month with both treatments. Measures of mood and memory were not significantly different for the two groups at any time point. The modest sample sizes of this study do not rule out a type II error in the detection of small but meaningful differences between assigned treatments. Also, the period of post-ECT observation consisted of 1 month of naturalistic treatment. Both RUL ECT at eight times the ST and BL ECT at 1.5 times the ST produce similar mood and memory effects. Both forms of ECT produced acceptable antidepressant response rates and only transient anterograde amnesia. No clear advantage emerged for either form of ECT, and both are justifiable as first-line techniques of ECT.
据报道，右侧单侧（RUL）电休克治疗（ECT）的记忆副作用比双侧（BL）ECT少。我们将癫痫发作阈值（ST）8倍的RUL ECT与ST 1.5倍的BL ECT进行了比较。患有重度抑郁症的成年人被随机分配接受ST 8倍的RUL ECT或ST 1.5倍的BL ECT。在ECT前、最后一次ECT后1至3天以及ECT后2周和4周进行情绪和记忆的盲法评分。40例患者接受了RUL ECT，37例接受了BL ECT。RUL组和BL组的抗抑郁反应率无显著差异（60%对73%）。两种治疗在第一个月都观察到持续的抗抑郁反应，并伴有顺行性记忆副作用的恢复。两组在任何时间点的情绪和记忆测量结果均无显著差异。本研究样本量较小，不能排除在检测指定治疗之间微小但有意义的差异时出现II类错误。此外，ECT后的观察期包括1个月的自然治疗。ST 8倍的RUL ECT和ST 1.5倍的BL ECT产生相似的情绪和记忆效果。两种形式的ECT都产生了可接受的抗抑郁反应率，且只有短暂的顺行性遗忘。两种形式的ECT均未显示出明显优势，两者均可作为ECT的一线技术。
