ECT versus tricyclic antidepressants in depression: a review of the evidence.

The claim is often made that ECT is more effective and works more rapidly than antidepressant drugs in the treatment of depression. The author reviews the nine controlled studies comparing the two treatments that appear in the literature. All of the studies were methodologically deficient, especially concerning definition of depression, sample size, dose of drug, and statistical analysis. No conclusive answer is available to the question whether ECT is superior to antidepressants in the treatment of depression. Pivotal studies are needed.