Paper A Day
I will try to review a paper a day, and idea borrowed from Anand of the Ergodic Walk. I'm not sure how successful I'll be, but hopefully posting my reviews on this here bloggie will add incentive.

Efficacy of ECT in Depression: A Meta-Analytic Review

Pagnin, D, Queiroz V, Pini S, Cassano G.

This study compared the efficacy of ECT over pharmacological approaches to treating depression. The study found that ECT is significantly superior in all comparisons [ECT vs placebo, vs antidepressants in general, vs TCA, vs MAOIs] and validated ECT as an appropriate therapeutic tool for treating depression.

Electroconvulsive Therapy : A Selected Review

Greenberg R, Kellner C

This article is a basic review about ECT. ECT is used most commonly in MDD, although it has also been shown to be useful in treating other psychiatric conditions including bipolar disorder, schizophrenia, PD, and NMS. As yet, there has been no evidence to suggest that any antidepressant medication is more effective than ECT in treating depression. Another advantage of ECT is that the response is usually faster than with antidepressant medication. In order for ECT to be effective, the seizures that are triggered should last at least 15 seconds and no more than three minutes. Of note is the fact that relapse rates in the 6-12 mo after ECT exceed 50% and are particularly high in the first few months after the initial response. The paper indicates that “there is preliminary evidence that nortriptyline-plus-lithium may be a safe and effective combination that may significantly reduce relapse rates of depression.” This suggestion is applicable to the treatment of my patient and I will bring it up with the Team at Rounds next week.