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ECT Effective for Treatment-Resistant Depression

ECT Effective for Treatment-Resistant Depression

Electroconvulsive therapy (ECT) may be beneficial and cost-effective for patients with treatment-resistant depression, according to a recent study.

Treatment-resistant depression (TRD) is a leading cause of premature mortality due to suicide and associated medical conditions and high social impairments, with large direct and indirect healthcare costs. Electroconvulsive therapy (ECT) is a procedure, done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental illnesses.

Eric L. Ross and his colleagues examined the cost-effectiveness of ECT versus pharmacotherapy/psychotherapy for treatment-resistant major depression.

Data were included from multiple meta-analyses, randomized trials, and observational studies

The researchers projected that over 4 years, ECT would reduce the amount of time that a patient experienced uncontrolled depression from roughly half of the patient’s life-years to roughly one-third of the patient’s life-years. The model predicted that greater improvements would be experienced if ECT were introduced earlier. There was an increase in mean health care costs by $7,300 to $12,000; the incremental costs were greater when ECT was offered earlier. Third-line ECT was cost-effective in the base case, with an incremental cost-effectiveness ratio of $54,000 per quality-adjusted-life-year.

Eric L. Ross, the lead author said that the main finding for clinicians is that ECT is a cost-effective treatment option for people with TRD, even though ECT is very expensive, its benefits are great enough to make it a good value.

The study found that offering ECT relatively early in the course of the depression treatment after a patient has failed to respond to two prior treatments, is cost-effective. In a range of univariate, scenario, and probabilistic sensitivity analyses, third-line ECT remained cost-effective.

The study concluded that from a health-economic point of view, ECT should be considered after failure of two or more lines of pharmacotherapy/psychotherapy.

The study was published in the journal JAMA Psychiatry

For more information log on to: doi:10.1001/jamaneurol.2018.0629

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Vinay Singh

Vinay Singh

Vinay Singh joined Medical Dialogue as Desk Editor in 2018. He covers the medical speciality news in different medical categories including Medical guidelines, updates from Medical Journals and Case Reports. He completed his graduation in Biotechnology from AAIDU and did his MBA from IILM Gurgaon. He can be contacted at . Contact no. 011-43720751
Source: With inputs from the journal JAMA Psychiatry

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