Citation

Park MJ, Kim H, Kim EJ, Yook V, Chung IW, Lee SM, Jeon HJ. Psychiatry Investig. 2021; 18(1): 1-10.

Copyright

(Copyright © 2021, Korean Neuropsychiatric Association)

DOI

10.30773/pi.2020.0350

PMID

unavailable

Abstract

OBJECTIVE Electro-convulsive therapy (ECT) has been established as a treatment modality for patients with treatment-resistant depression and with some specific subtypes of depression. This narrative review intends to provide psychiatrists with the latest findings on the use of ECT in depression, devided into total eight sub-topics.

METHODS We searched PubMed for English-language articles using combined keywords and tried to analyze journals published from 1995-2020.

RESULTS Pharmacotherapy such as antidepressants or maintenance ECT is more effective than a placebo as prevention of recurrence after ECT. The use of ECT in treatment-resistant depression, depressed patients with suicidal risks, elderly depression, bipolar depression, psychotic depression, and depression during pregnancy or postpartum have therapeutic benefits. As possible mechanisms of ECT, the role of neurotransmitters such as serotonin, dopamine, gamma-aminobutyric acid (GABA), and other findings in the field of neurophysiology, neuro-immunology, and neurogenesis are also supported.

CONCLUSION ECT is evolving toward reducing cognitive side effects and maximizing therapeutic effects. If robust evidence for ECT through randomized controlled studies are more established and the mechanism of ECT gets further clarified, the scope of its use in the treatment of depression will be more expanded in the future. © 2021 Korean Neuropsychiatric Association.

Language: en

Keywords

human; Depression; Suicide; Review; quality of life; bipolar disorder; abdominal pain; depression; prevalence; schizophrenia; suicide attempt; major depression; hospitalization; bipolar depression; Electroconvulsive therapy; repetitive transcranial magnetic stimulation; serotonin; antidepressant agent; hydrocortisone; paroxetine; venlafaxine; quetiapine; dopamine; electroconvulsive therapy; neurotransmitter; nonhuman; thyrotropin; placebo; seizure; dopamine receptor; olanzapine; computer assisted tomography; depressive psychosis; alopecia; heart arrhythmia; 4 aminobutyric acid; aripiprazole; brain ischemia; nervous system development; brain derived neurotrophic factor; Positive and Negative Syndrome Scale; blood brain barrier; neurophysiology; neuropeptide Y; neural tube defect; postnatal depression; randomized controlled trial (topic); glial cell line derived neurotrophic factor; Medline; angiogenesis; meta analysis (topic); treatment resistant depression; dexmedetomidine; vasculotropin; Hamilton Depression Rating Scale; neuroimmunology