EFFICACY OF ELECTROCONVULSIVE THERAPY IN TREATMENT - RESISTANT DEPRESSION

Objective: To evaluate the effectiveness of electro convulsive therapy among patients with treatment resistant depression.Study Design: Descriptive case series study.Place and Duration of Study: Study was conducted at AFIMH Rawalpindi, from Apr to Oct 2017.Patients and Methods: A total of 47 patients with treatment-resistant depression with or without psychotic features of age 18-65 years of either gender were included in the study using non-probability purposive sampling, technique. Patients were first diagnosed as per the criteria of International classification of diseases (ICD) version 10 after detailed history and were advised ECT for treatment resistant depression when there was no significant clinical improvement or outcome with two trials of antidepressants from different pharmacological groups along with psychotherapy for at least 6-8 weeks or no clinical response to one or two courses of an anti-depressant/antipsychotic combination in case of psychotic symptoms. The written informed consent was obtained from the patients. They were then assessed by applying the efficacy assessment tool, 21 item Hamilton depression rating scale (HAM-D) before and after 6 sessions (3 weeks) of electroconvulsive therapy.Results: Mean age in the study was 40.77 ± 11.82 years. Out of the 47 patients, 17 (36.17%) were male and 30 (63.83%) were females with male to female ratio of 1:1.8. Efficacy of electroconvulsive therapy in patients with treatment -resistant depression was found in 39 (82.98%) patients with improvement in score from severe (>20) to mild/normal (20) on 21-item HAM-D rating scale.Conclusion: This study concluded that efficacy of electroconvulsive therapy in patients with treatment-resistant depression was overall high in our setting with no major difference found in efficacy with respect to variables like age, gender, and psychosis.