Sackeim H A, Decina P, Kanzler M, Kerr B, Malitz S
Department of Biological Psychiatry, New York State Psychiatric Institute, NY 10032.
Am J Psychiatry. 1987 Nov;144(11):1449-55. doi: 10.1176/ajp.144.11.1449.
This double-blind, random-assignment study contrasted the relative efficacy of bilateral and unilateral right ECT with a low-dose titration procedure. In 52 patients with primary major depressive disorder, bilateral ECT was markedly superior in short-term symptom reduction to unilateral right ECT. The two conditions did not differ in the duration of generalized seizures or in the number of treatments administered to achieve clinical response. The findings challenge the claim that the elicitation of generalized seizure is, in and of itself, sufficient for the antidepressant properties of ECT. Rather, a dose in excess of seizure threshold may contribute to the efficacy of ECT, particularly with a unilateral right electrode placement.
这项双盲、随机分配研究通过低剂量滴定程序对比了双侧和单侧右侧电休克疗法（ECT）的相对疗效。在52例原发性重度抑郁症患者中，双侧ECT在短期症状缓解方面明显优于单侧右侧ECT。两种治疗条件下，全身性癫痫发作的持续时间或为达到临床反应所给予的治疗次数并无差异。这些发现对以下观点提出了质疑：即全身性癫痫发作本身就足以产生ECT的抗抑郁特性。相反，超过癫痫阈值的剂量可能有助于ECT发挥疗效，尤其是在采用单侧右侧电极放置时。
