Comparing Low Amplitude Pulse Seizure Therapy to Standard Right Unilateral Electroconvulsive Therapy for Reducing Suicidal Thoughts

What this Trial Is About

This research aims to compare two forms of electroconvulsive therapy ECT for patients experiencing suicidal thoughts, particularly those with treatment-resistant psychiatric disorders such as major depressive disorder, bipolar disorder, and schizoaffective disorder. The study focuses on whether Right Unilateral Low-Amplitude Pulse Seizure Therapy RUL LAP-ST offers a better remission rate of suicidal ideation compared to standard Right Unilateral Electroconvulsive Therapy RUL ECT, while potentially causing fewer memory and cognitive side effects. This trial includes adult patients referred for ECT due to suicidal ideation and related mood or psychotic disorders. Participants will be randomly assigned to receive either RUL LAP-ST at 600mA or 700mA or the conventional RUL ECT at 800mA. The study uses devices such as Sigma-Stim to deliver these treatments. Both treatments involve ultra-brief pulse amplitude seizure therapy, with the trial designed to evaluate the differences in effectiveness and side effects over an average treatment period of four weeks. The study is double-blinded and includes a parallel design comparing these two arms. During the study, participants will be monitored through self-reports and clinician assessments focusing on suicidal ideation and depression levels. Various scales, including the Montgomery-Asberg Depression Rating Scale, will be used to measure outcomes. The study aims to assess remission of suicidal ideation as the primary outcome alongside secondary depression outcomes. Participants will remain in the study for about four weeks, during which their cognitive effects and safety will be closely observed. The trial is sponsored by Michigan State University and runs until December 2026.

Low Amplitude Pulse Seizure Therapy Versus Standard Ultra-Brief Right Unilateral Electroconvulsive Therapy