Gonuguntla Rishi, Dunham Sam, Benmaman Isaac, Gonuguntla Neha, Ha Kevin
From the Department of Psychiatry, Washington University in St. Louis, St. Louis, WA.
Department of Psychiatry, UT Health Science Center San Antonio, San Antonio, UT.
J ECT. 2025 Jun 9. doi: 10.1097/YCT.0000000000001164.
Electroconvulsive therapy (ECT) is an interventional psychiatric technique used primarily to address treatment resistant psychiatric disorders. There are many different stimulus electrode placements and pulse widths utilized in the administration of this therapy, but it is presently unclear which is optimal. The aim of this study is to assess the relative efficacy and side-effect profile of ultrabrief pulse width ECT (UBP ECT) and brief-pulse width ECT (BP ECT) in the treatment of major depressive disorders.
A systematic review of the literature was performed. Studies were identified from PubMed, MEDLINE and PsycINFO between January 2013 to October 2023. The final search terms included ECT, depression, brief pulse, and ultrabrief pulse.
The search initially included 64 studies. Forty-three of these studies were not duplicates, after applying exclusion criteria 11 studies were included. UBP ECT was found to have fewer cognitive side effects than BP ECT. Additionally, patients undergoing BP ECT were found to discontinue treatment more frequently due to inability to tolerate side effects. Despite this, BP ECT may have higher rates of symptom remission than UBP ECT. Further studies should be done to clarify the outcomes of each technique.
The current evidence slightly favors UBP ECT due to its beneficial side effect profile compared to BP ECT while it has a similar efficacy. However, there is insubstantial evidence in the current body of literature. Additional studies are required to determine which of these techniques is safer and more efficacious in the treatment of major depressive disorders.
Systematic review.
电休克治疗（ECT）是一种主要用于治疗难治性精神障碍的介入性精神科技术。在这种治疗的实施过程中，使用了许多不同的刺激电极放置方式和脉冲宽度，但目前尚不清楚哪种是最佳的。本研究的目的是评估超短脉冲宽度电休克治疗（UBP ECT）和短脉冲宽度电休克治疗（BP ECT）在治疗重度抑郁症方面的相对疗效和副作用情况。
对文献进行系统综述。从2013年1月至2023年10月期间的PubMed、MEDLINE和PsycINFO中检索相关研究。最终的检索词包括ECT、抑郁症、短脉冲和超短脉冲。
初步检索到64项研究。其中43项研究不重复，应用排除标准后纳入11项研究。发现UBP ECT的认知副作用比BP ECT少。此外，接受BP ECT治疗的患者因无法耐受副作用而更频繁地中断治疗。尽管如此，BP ECT的症状缓解率可能比UBP ECT高。应进行进一步研究以明确每种技术的结果。
目前的证据略微支持UBP ECT，因为与BP ECT相比，其副作用情况较好，且疗效相似。然而，目前的文献证据不足。需要更多研究来确定这两种技术中哪种在治疗重度抑郁症时更安全、更有效。
系统综述。
