Optimizing Electroconvulsive Therapy in Difficult-to-Treat Depression by Comparing Right Unilateral and Bitemporal Electrode Positions After Early Non-Response

What this Trial Is About

Researchers are evaluating two different electrode positions for electroconvulsive therapy ECT in adults with difficult-to-treat depression who do not show early improvement during an acute ECT course. The trial aims to compare continuing right unilateral RUL ECT versus switching to bitemporal BT ECT to see which approach speeds recovery and has less impact on memory. The study also follows depressive symptoms and cognitive performance up to three months after treatment. Participants who do not respond after four ECT sessions are randomly assigned to either continue with RUL ECT or switch to BT ECT until remission is reached. Treatments are delivered using different electrode placements on the ECT device. Assessments occur at baseline, after four and eight ECT sessions, at the end of the acute course up to seven weeks, and three months later. During the study, mood and neurocognitive tests, including assessments of autobiographical memory and various cognitive performance measures, are performed at multiple time points. Researchers track changes in depressive symptoms and memory function to understand treatment effects. The trial includes monitoring up to three months post-treatment to observe recovery and cognitive outcomes.

Changing Tactics? Optimizing ECT in Difficult-to-treat Depression