Shapira B, Gorfine M, Lerer B
Depression Treatment Unit, Herzog Hospital, Jerusalem, Israel.
Convuls Ther. 1995 Jun;11(2):80-5.
Twenty-eight of 34 patients with major depression who completed a course of electroconvulsive therapy (ECT) and were classified as responders were administered lithium carbonate (Li) continuation therapy in the context of an open, prospective study. Twenty-four patients were followed for 6 months or until relapse; four patients dropped out of follow-up while still in remission. The probability of completing 6 months without relapse (by survival analysis, including the patients who dropped out as censored observations) was 65%. The eight patients who relapsed into depression all did so within 13 weeks. They were characterized by a shorter duration of their index depressive episode, a greater likelihood of having suffered an additional depressive episode in the preceding 12 months, and failure of an adequate trial of antidepressant medication before the ECT course. Novel pharmacological strategies may be needed in the post-ECT continuation therapy of patients who have a prior history of relapse and are demonstrably resistant to antidepressant medication.
34例重度抑郁症患者完成了一个疗程的电休克治疗（ECT）并被归类为有效者，其中28例在一项开放性前瞻性研究中接受了碳酸锂（Li）维持治疗。24例患者随访6个月或直至复发；4例患者在仍处于缓解期时退出随访。通过生存分析（包括将退出者作为截尾观察），6个月无复发的概率为65%。8例复发为抑郁症的患者均在13周内复发。他们的特点是首次抑郁发作的持续时间较短，在前12个月内有再次发生抑郁发作的更大可能性，以及在ECT疗程之前未充分试用抗抑郁药物。对于有复发史且对抗抑郁药物明显耐药的患者，ECT后维持治疗可能需要新的药理学策略。
