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Tijdschrift voor Psychiatrie 47 (2005) 6, 351 - 358

New research

Effect of antidepressant medication resistance on short-term response to electroconvulsive therapy

A.A. de Lely, W.W. van den Broek, P.G.H. Mulder, T.K. Birkenhäger, J.A. Bruijn

background Previous research has shown that patients with resistance to antidepressant pharmacotherapy are less likely to respond to electroconvulsive therapy (ect). This finding may be applicable to depressed inpatients in the Netherlands, where ect is often preceded by courses of treatment with various drugs.
aim To assess the influence of medication resistance on the short-term response to ect.
method   A prospective study was carried out, based on 85 patients who satisfied dsm iv criteria for depressive disorder. Medication resistance was rated in accordance with previous research in this field.
results   The response to ect (defined as a reduction of at least 50% on the 17-item version of the Hamilton Rating Scale for Depression (hrsd)) of medication-resistant patients was almost identical to the response of patients without medication resistance (82.5% versus 81.1%). Even when full remission (defined as a post-ect hrsd score ≤ 7) was used as a criterion for assessing the result, there was no significant difference between medication-resistant patients and patients without medication resistance (43.8% versus 40.5%). When potential confounding variables were taken into account, these differences remained nonsignificant.
conclusion   In contrast to earlier American research, our study shows that medication resistance does not influence short-term response to ect. ect is an effective treatment, even for medication-resistant depressive patients.



keywords depressive disorder, drug resistance, electroconvulsive therapy