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The British Journal of Psychiatry (2005) 187: 487
© 2005 The Royal College of Psychiatrists

Correspondence

ECT in depression

R. Euba

Memorial Hospital, Shooters Hill, London SE18 3RZ, UK.

Correspondence: E-mail: Rafael.Euba{at}oxleas.nhs.uk

EDITED BY KIRIAKOS XENITIDIS and COLIN CAMPBELL

Schulze-Rauschenbach et al (2005) found in their comparison of unilateral electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) that these two procedures have similar efficacy in the treatment of major depression. However, the rate of treatment response for ECT in their study was 46%, well below the figures found in other studies (Medical Research Council, 1965). The authors state that the response rate for ECT might have been higher if a higher dosage had been used, but that this would have increased the risk of side-effects. This argument is misleading, just as comparing a sub-therapeutic dose of amitriptyline and placebo would be. The authors should have compared the incidence of side-effects between treatments, but at therapeutic doses. This comparison would probably have confirmed the prevalent belief that ECT is more effective than rTMS in the treatment of major depression (Aarre et al, 2003).

REFERENCES

Aarre, T. F., Dahl, A. A., Johansen, J. B., et al (2003) Efficacy of repetitive transcranial magnetic stimulation in depression: a review of the evidence. Nordic Journal of Psychiatry, 57, 227 –232.[Medline]

Medical Research Council (1965) Chemical trial of the treatment of depressive illness. BMJ, i, 881 –886.

Schulze-Rauschenbach, S. C., Harms, U., Schlaepfer, T. E., et al (2005) Distinctive neurocognitive effects of repetitive transcranial magnetic stimulation and electroconvulsive therapy in major depression. British Journal of Psychiatry, 186, 410 –416.[Abstract/Free Full Text]





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