Journal of affective disorders · 2025
Efficacy and safety of lower dose electroconvulsive therapy for major depression in adolescents with suicide ideation: A non-inferiority randomized controlled trial in China.
СтатьяРандомизированное исследованиеEquivalence TrialНазвание и аннотация: Перевод пока не подготовлен
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Du Ruonan, Zhao Shaokun, Zhang Xueying, Li Wei, Ma Yunhui, Zhang Yucong, Zhang Ziyou, Yu Yongjun, Wang Yanan, Yang Kebing, Wang Zhiren, Cai Haipeng
Аннотация
OBJECTIVE: This study compared the efficacy and cognitive adverse effects of 40 % × age dose electroconvulsive therapy (ECT) with those of 80 % × age dose ECT in adolescent patients with major depressive disorder and suicidal ideation.
METHOD: The study conducted a double-blind randomized clinical trial from May 2024 to April 2025 at Beijing Huilongguan hospital using a non-inferiority design. Patients were recruited and randomly assigned 1:1 to eight sessions of bilateral temporal 40 % × age dose (72 patients: mean [SD] age, 15.51 [1.27] years) or 80 % × age dose ECT (71 patients: mean [SD] age, 15.55 [1.44] years). The study set the electrical stimulation based on "half-age" method. The primary outcome was the patient's depressed mood, assessed using the 17-item Hamilton Depression Rating Scale (HDRS-17).
RESULTS: HDRS-17 scores reduced after treatment in both 40 % × age dose and 80 % × age dose ECT groups. 40 % × age dose ECT was not inferior to 80 % × age dose ECT as a treatment for depressive symptoms.
CONCLUSIONS: Lower dose ([40 % × age] joules) ECT is not inferior to usual dose ([80 % × age] joules) ECT in treating adolescent patients with major depressive disorder and is safer. Patients treated with 40 % × age dose ECT showed improvement in visual learning and social cognitive function. Therefore, lower dose ECT can be prioritized in clinical practice in adolescent patients.
CLINICAL TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR2400085047.
METHOD: The study conducted a double-blind randomized clinical trial from May 2024 to April 2025 at Beijing Huilongguan hospital using a non-inferiority design. Patients were recruited and randomly assigned 1:1 to eight sessions of bilateral temporal 40 % × age dose (72 patients: mean [SD] age, 15.51 [1.27] years) or 80 % × age dose ECT (71 patients: mean [SD] age, 15.55 [1.44] years). The study set the electrical stimulation based on "half-age" method. The primary outcome was the patient's depressed mood, assessed using the 17-item Hamilton Depression Rating Scale (HDRS-17).
RESULTS: HDRS-17 scores reduced after treatment in both 40 % × age dose and 80 % × age dose ECT groups. 40 % × age dose ECT was not inferior to 80 % × age dose ECT as a treatment for depressive symptoms.
CONCLUSIONS: Lower dose ([40 % × age] joules) ECT is not inferior to usual dose ([80 % × age] joules) ECT in treating adolescent patients with major depressive disorder and is safer. Patients treated with 40 % × age dose ECT showed improvement in visual learning and social cognitive function. Therefore, lower dose ECT can be prioritized in clinical practice in adolescent patients.
CLINICAL TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR2400085047.