Conference Coverage

ECT more effective for psychotic vs. nonpsychotic depression?


 

Confirmatory data

Commenting on the findings for Medscape Medical News, Georgios Petrides, MD, associate professor of psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, East Garden City, New York, noted that differences in response to ECT between patients with psychotic depression and those with nonpsychotic depression are “well known.”

However, “it’s actually good to present more data that confirm what people are doing in clinical practice,” said Petrides, who was not involved with the research.

Petrides noted that some guidelines recommend ECT as first-line treatment for psychotic depression.

“For nonpsychotic depression, we’d try medications, psychotherapy, and everything else first,” he said. He noted that the current results are “a good replication of what is known so far.”

As to why ECT should be more effective for patients with psychotic depression, he said, “A lot of people think that the biology of psychotic depression is different from the biology of nonpsychotic depression.”

Many things that ECT “corrects” are disturbed in psychotic depression, including cortisol homeostasis, which is thought to be affected via the hypothalamic-pituitary-adrenal axis, Petrides added.

That ECT is more effective in psychotic depression is an “indirect point of evidence” to support that theory.

One aspect that has traditionally dogged the use of ECT has been the stigma that surrounds the procedure, Petrides noted. That’s “always an issue, but it’s getting less and less over time,” he said.

He added that ECT is extremely safe and that it is associated with the “lowest mortality for any procedure performed under general anesthesia,” which helps to reduce the stigma around it, he noted.

The study authors and Petrides have reported no relevant financial relationships.

This article first appeared on Medscape.com.

Pages

Recommended Reading

Psychiatric manifestations of sport-related concussion
MDedge Psychiatry
‘Nietzsche was wrong’: Past stressors do not create psychological resilience.
MDedge Psychiatry
Beefed up inpatient/outpatient care transition is key to suicide prevention
MDedge Psychiatry
Meditations in an emergency: Talking through pandemic anxiety with a pioneer of mind-body medicine
MDedge Psychiatry
International medical graduates facing challenges amid COVID-19
MDedge Psychiatry
Helping families understand internalized racism
MDedge Psychiatry
Repetitive hits to the head tied to depression, poor cognition in later life
MDedge Psychiatry
MDD: Verbal learning deficit may be a potential marker for suicide risk
MDedge Psychiatry
Vitamin D supplementation may reduce negative symptoms of MDD
MDedge Psychiatry
More U.S. psychiatrists restricting practices to self-pay patients
MDedge Psychiatry