Depression treated with imipramine and ECT: the DeCarolis study reconsidered.

The authors reevaluate a large prospective Italian study (437 patients) that compared high-dose imipramine with ECT treatment in the treatment of depression. The superiority of ECT was evident among patients with endogenous depression, and especially evident among those with delusional depression (83% improved with ECT versus 40% with imipramine) and depressions defined as severe (83% versus 35%).