ECT of major depressed patients in relation to biological and clinical variables: A brief overview

Abstract

The knowledge that spontaneous or induced convulsions can improve mentaldisorders has been present for severalcenturies. electroconvulsive therapy (ECT) has undergone fundamentalchanges since its introduction, and in the last 15-20 years there has been a legitimate renewalof interest for this therapy. Today the indications for use of ECT seem wellcodified, and its technique and practices have evolved considerably. It is now firmly established as an important and effective method of treating certain severe forms of depression. However, stillvery little is known about the mechanism of ECT. In this paper, first, we willgive a short overview as to how far we have got concerning ECT in relation to various clinicaland biologicalvariables. Second, we willdescribe ECT in relation to electroencephalographic (EEG) technique and clinicaloutcome as wellas give some proposals as to how to go on with the data analysis of EEG. In conclusion, the superior effect of ECT compared to other antidepressives in severe depression may depend on neurochemical and neurobiologicalcascade effects initiated by repeated treatments. Above all, ECT offers a unique experimentalopportunity to study how neuromodulation of the major transmitter systems may be involved in brain dynamics and alteration of connectivity. © 2003 Nature Publishing Group.