Do benzodiazepines moderate the effectiveness of bitemporal electroconvulsive therapy in major depression?

• Published in: Journal of affective disorders 2013-09, Vol.150 (2), p.686-690
• Main Authors: Gálvez, Verònica, Loo, Colleen K, Alonzo, Angelo, Cerrillo, Ester, Menchón, José Manuel, Crespo, José Manuel, Urretavizcaya, Mikel
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; Benzodiazepines; Benzodiazepines - therapeutic use; Biological and medical sciences; Bitemporal; Combined Modality Therapy; Depression; Depressive Disorder, Major - therapy; Dosage; Efficacy; Electroconvulsive Therapy; Female; Humans; Major depression; Male; Medical sciences; Middle Aged; Mood disorders; Moods; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Regression Analysis; Retrospective Studies; Treatment Outcome; Treatments
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2013.03.028

Abstract Background Electroconvulsive therapy (ECT) is the most effective treatment for depression. However, the use of concomitant medications during ECT is controversial, especially benzodiazepines, as some past evidence suggests these may reduce the efficacy of ECT. This study analysed the effect of benzodiazepines on treatment outcomes in a group of depressed patients treated with bitemporal (BT) ECT. Methods 90 patients with major depression who received BT ECT were analysed. Clinical, demographic and ECT data were extracted from clinical records. Mood improvement was rated by trained psychiatrists using the Hamilton Depression Rating Scale (HDRS-21) at baseline and after the final ECT treatment. The association between benzodiazepine dose and mood outcomes over the ECT course was examined with regression analyses, controlling for variables that may affect ECT efficacy. Results Hierarchical multiple regression analysis found only current episode duration ( t =−4.77, p 0.05, R2 =0.39). Limitations This was a retrospective study. The use of the half-age dosing method for ECT did not permit examination of the effects of benzodiazepines on seizure threshold. Conclusions Benzodiazepines did not affect the efficacy of BT ECT with the dosing method used. However, these results may not generalise to other forms of ECT, ECT given with other methods of dose determination or to other populations less responsive to ECT.