Frederikse Melissa, Petrides Georgios, Kellner Charles
Department of Psychiatry, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, 07103, USA.
J ECT. 2006 Mar;22(1):13-7. doi: 10.1097/00124509-200603000-00003.
Continuation and maintenance electroconvulsive therapy (ECT) is used to prevent relapse and recurrence of depressive episodes in those patients who have failed previous continuation and/or maintenance pharmacotherapy and who have also responded to an acute course of ECT. These patients frequently have histories of medication-resistant depression, medication intolerance, and/or comorbid medical conditions that complicate the management of their psychiatric illness. Previous studies of continuation and maintenance ECT, mostly consisting of case reports and retrospective chart reviews, as well as several prospective studies, support the practice of continuation and maintenance ECT as a viable treatment option for these difficult-to-treat patients. However, continuation and maintenance ECT have come under fire recently because of concerns of insufficient controlled studies demonstrating its efficacy, its long-term benefits, and its risks. This article thus reviews the most recent data available on the use of continuation and maintenance ECT in the treatment of depressive disorders. Although few new prospective controlled studies exist in the literature, published and emerging data continue to support the use of continuation and maintenance ECT, particularly in those individuals with medication-refractory, ECT-responsive, and relapse-prone depression.
延续性和维持性电休克治疗（ECT）用于预防那些既往延续性和/或维持性药物治疗失败且对ECT急性疗程有反应的患者抑郁发作的复发。这些患者常有难治性抑郁症、药物不耐受和/或合并躯体疾病的病史，这些情况使他们精神疾病的管理变得复杂。既往关于延续性和维持性ECT的研究，大多是病例报告和回顾性病历审查，以及一些前瞻性研究，支持将延续性和维持性ECT作为这些难治性患者的一种可行治疗选择。然而，延续性和维持性ECT最近受到了抨击，因为担心缺乏充分的对照研究来证明其疗效、长期益处和风险。因此，本文回顾了关于使用延续性和维持性ECT治疗抑郁症的最新可用数据。尽管文献中几乎没有新的前瞻性对照研究，但已发表和新出现的数据继续支持使用延续性和维持性ECT，特别是在那些药物难治性、ECT反应性和易复发抑郁症患者中。
