Response rate and safety of antidepressants combined with electroconvulsive therapy in adolescent depression: Real-world clinical application

•Currently, electroconvulsive therapy (ECT) is less commonly used to treat adolescent depression than adult depression, owing to a limited evidence base in the medical literature. This study included 210 depression patients receiving antidepressants and ECT. The symptoms of depression were examined with the Hamilton Depression Scale (HAMD) and Clinical Global Impressions Scale (CGI) at baseline and the end of treatment. Response and safety were compared among adolescent and adult patients. For adolescents, the response rate (much improved or very much improved) was 80.9 %, and CGI-Severity (CGI-S), HAMD, and suicide factor scores were significantly changed as compared to baseline (P 0.05). Notably, adolescents expressed stronger suicidal intent than adults, and ECT observably relieved it. Side effects (memory problems, headache, nausea/vomiting, muscle soreness) in adolescents were not statistically different from those in adults (P > 0.05). As data were derived from a single center, the generalizability of results may be limited, and the potential factors affecting the efficacy of ECT were not further explored. Antidepressants combined with ECT are associated with high response rate and safety for treating depression, regardless of age. A stronger expression of suicide ideation was observed in depressed adolescents, and side effects of ECT were similar to the adults. •The CGI-I, CGI-S, HAMD and suicide factor scores of depressed adolescents showed significant differences before and after ECT.•Depressed adolescents showed higher prevalence of suicidal ideation than adults before ECT in the real-world data.•The efficacy and side effects of antidepressants combined with ECT in adolescents were similar to those observed in adults.