Third-Line Electroconvulsive Therapy May Be Best for Patients With Treatment-Resistant Depression

Clinicians may want to consider electroconvulsive therapy (ECT) for patients with major depressive disorder who have failed to respond to two trials of pharmacotherapy and/or psychotherapy, according to the authors of astudy published this week inJAMA Psychiatry.“As clinicians we always worry about patients getting routed through treatment after treatment, at which point they become more treatment resistant,” senior author Daniel Maixner, M.D., who directs the ECT program at Michigan Medicine, toldPsychiatric News. Decades of research have shown that ECT is the most effective way of achieving remission in patients with treatment-resistant depression (TRD), he noted. The findings of this study suggest ECT is also cost-effective earlier in the treatment course of depression.Relying on data from published depression studies, including the STAR*D (Sequenced Treatment Alternatives to Relieve Depression) trial, Maixner together with Eric Ross, M.D., and Kara Zivin, Ph.D., of the University of Michigan Department of Psychiatry used a mathematical model to simulate cost and quality-of-life outcomes for patients with TRD who are exposed to different treatments.The model projected that over four years, ECT would reduce time with uncontrolled depression from 50% of life-years to between 32% and 37% of life-years, with greater improvements the earlier ECT is offered. The model also predicted that offering ECT as a third-line treatment for depression would cost an estimated $54,000 pe...
Source: Psychiatr News - Category: Psychiatry Tags: Charles Kellner cost-effectiveness Daniel Maixner electroconvulsive therapy Eric Ross Kara Zivin treatment-resistant depression Source Type: research