Bifrontal ECT: A Systematic Review and Meta-Analysis of Efficacy and Cognitive Impact

Authors: Plakiotis, Chris; O'Connor, Daniel W.

Source: Current Psychiatry Reviews, Volume 5, Number 3, August 2009 , pp. 202-217(16)

Publisher: Bentham Science Publishers

Abstract:

The aim of this paper is to review the literature regarding bifrontal electroconvulsive therapy (ECT) and provide recommendations for future research in this area. Original publications were retrieved using PubMeD, EMBASE, PsycINFO, and Google Scholar. A systematic review and meta-analysis of randomised clinical trials examining efficacy and/or cognitive effects of bifrontal ECT for the treatment of depression is the centrepiece of this paper. The literature regarding bifrontal ECT is limited, with small patient numbers and treatment variation across studies complicating result interpretation. However, our findings suggest that while bifrontal and bitemporal ECT may have similar efficacy, bifrontal ECT is associated with less cognitive impairment immediately after a treatment course. Bifrontal ECT may have greater efficacy than low-dose right unilateral ECT but less efficacy than high-dose right unilateral ECT. Conversely, bifrontal ECT may affect cognition more adversely than low-dose right unilateral ECT, but less so than high-dose right unilateral ECT. To further investigate the likely favourable benefit to cognitive risk profile of bifrontal ECT, detailed cognitive testing should be undertaken as part of any future, large scale studies comparing the efficacy of adequately-dosed bifrontal, bitemporal and right unilateral ECT.

Keywords: Bifrontal; electroconvulsive therapy; depression; meta-analysis

Document Type: Research article

Publication date: 2009-08-01

More about this publication?

• Current Psychiatry Reviews publishes frontier reviews on all the latest advances on clinical psychiatry and its related areas e.g. pharmacology, epidemiology, clinical care, and therapy. The journal's aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all clinicians, psychiatrists and researchers in psychiatry.

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