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ECT is superior to pharmacotherapy for the short-term treatment of medication-resistant inpatients with bipolar depression
  1. Axel Nordenskjöld
  1. School of Health and Medical Sciences, Örebro University, Örebro, Sweden;

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ABSTRACT FROM: Schoeyen HK, Kessler U, Andreassen OA, et al. Treatment-resistant bipolar depression: a randomized controlled trial of electroconvulsive therapy versus algorithm-based pharmacological treatment. Am J Psychiatry 2015;172:41–51.

What is already known on this topic

Within 1–4 years, about one-fourth of stable patients with bipolar disorder suffer from depression despite prophylactic lithium therapy.1 Electroconvulsive therapy (ECT) is equally effective for unipolar and bipolar depression,2 however, the rate of use of ECT varies considerably between countries,3 and, in clinical guidelines, ECT is often considered only after multiple pharmacological agents have been tried.4 This is probably due to the paucity of randomised studies directly comparing the effects of pharmacotherapy and ECT for bipolar depression. Moreover, it remains unclear whether the memory impairments seen in some patients treated with ECT are attributable to the disease or to the treatment.

Methods of the study

This Norwegian multicentre randomised trial enrolled 73 inpatients suffering from bipolar depression. The two …

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