A Retrospective Study of Postictal Suppression during Electroconvulsive Therapy.

BACKGROUND

electroconvulsive therapy (ECT) is the most effective treatment in treatment-resistant depression (TRD), but its response remains partial. Identifying useful indicators to guide decision making for treatment and improve clinical response remains a major issue. The objective of the present retrospective study was to determine if clinical response-early (after 5 ECT sessions) or longer-term (after 12 ECT sessions)-was associated with postictal suppression during the first ECT course and/or with postictal suppression frequency during the whole ECT course.

METHODS

in a retrospective study, the data of 42 patients suffering from treatment-resistant depression and receiving at least 5 ECT sessions were collected. Two sessions per week of bitemporal brief-pulse ECT sessions were administered to patients. Each of the electroencephalography (EEG) recordings were assessed to determine the presence of postictal suppression.

RESULTS

the postictal suppression from the first ECT session predicted a better long-term clinical response (after 12 ECT sessions), but not early clinical response (after only 5 ECT sessions). The postictal suppression frequency was associated with neither the short- nor the long-term clinical response. In addition, postictal suppression and short-term cognitive performances were not associated.

CONCLUSIONS

this EEG indicator is clinically useful if it appears in the first ECT sessions, but it is no longer relevant in the following sessions.