My psychiatrist Dr. A tore out for me a new article from this month’s Archives of General Psychiatry entitled “Effect of Concomitant Pharmacotherapy on Electroconvulsive Therapy Outcomes.” Written by Harold Sackeim, et al., their research found that “treatment with nortriptyline (a second-generation tricyclic) enhanced the efficacy and reduced the cognitive adverse effects of ECT relative to the placebo, and Venlafaxine (Effexor) resulted in weaker degree of improvement and tended to worsen cognitive adverse effects (but still better than placebo).” They also concluded that high-dosage right unilateral ECT equaled or surpassed in efficacy to bilateral ECT and caused less cognitive side effects. (Here’s an article about this study from Medical News Today.)
We’ve probably encountered the stats that the effectiveness of ECT is somewhere between 70-90%. Though I wasn’t led to believe that I would be free from medication after the ECT, but it wasn’t made that clear to me that without any augmentation the relapse rate for ECT is around 50%, and according to one 2007 study, the rate could be up to 100%. So, I’d like to think that ECT just eradicates our lifetime of madness, but we need to realize that there are still work to be done after the little sparks are over. That may mean just continuing with your old meds, adding lithium, or turning back to ECT. I know that by the time we’re considering ECT, we are barely able to make it through the day, but I think it’s better to ask and know upfront what turns your life could take post-ECT rather than be surprised by something that’s already been documented that it might happen.
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