A randomized controlled trial comparing the memory effects of continuation electroconvulsive therapy versus continuation pharmacotherapy: Results from the Consortium for Research in ECT (CORE) study

Glenn E. Smith, Keith G. Rasmussen, C. Munro Cullum, M. Donna Felmlee-Devine, Georgios Petrides, Teresa A. Rummans, Mustafa M. Husain, Martina Mueller, Hilary J. Bernstein, Rebecca G. Knapp, M. Kevin O'Connor, Max Fink, Shirlene Sampson, Samuel H. Bailine, Charles H. Kellner

Research output: Contribution to journalArticle

37 Scopus citations

Abstract

Objective: To compare the memory effects of continuation electroconvulsive therapy (C-ECT) versus continuation pharmacologic intervention (C-PHARM) at 12 and 24 weeks after completion of acute electroconvulsive therapy (ECT). Method: Eighty-five patients with Structured Clinical Interview for DSM-IV-diagnosed unipolar major depressive disorder, enrolled in a multisite, randomized, parallel-design trial conducted at 5 academic medical centers from 1997 to 2004, who had remitted with an acute course of bilateral ECT and remained unrelapsed through 24 weeks of continuation therapy, were included in this analysis. They were randomly assigned to C-ECT (10 treatments) or nortriptyline plus lithium (monitored by serum blood levels) for 24 weeks. Objective neuropsychological measures of retrograde and anterograde memory and subjective assessment of memory were obtained at baseline, 12 weeks, and 24 weeks. The Rey Auditory-Verbal Learning Test and the Autobiographical Memory Interview were the primary outcome measures. Results: The C-PHARM group showed a greater group difference (P < .01) for baseline to 12-week change for the Autobiographical Memory Interview. No other memory measures showed group differences for change scores from baseline to 12 weeks. Groups showed no baseline to 24-week change-score differences on any of the memory measures. For both groups, 12-week objective anterograde memory scores (eg, Auditory-Verbal Learning Test percent retention P = .0001; Rey-Osterrieth Complex Figure or Taylor Figure percent retention P < .002) and 24-week subjective memory scores were significantly improved (Squire Subjective Memory Questionnaire P < .02) over baseline. This result reflects the apparent resolution of a presumed decrement in anterograde memory associated with acute ECT preceding this study. Conclusions: The finding of no memory outcome differences between unrelapsed recipients of C-ECT and C-PHARM is consistent with clinical experience. Memory effects have only a small role in the choice between C-ECT and C-PHARM.

Original languageEnglish (US)
Pages (from-to)185-193
Number of pages9
JournalJournal of Clinical Psychiatry
Volume71
Issue number2
DOIs
StatePublished - Feb 1 2010

ASJC Scopus subject areas

  • Psychiatry and Mental health

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    Smith, G. E., Rasmussen, K. G., Cullum, C. M., Felmlee-Devine, M. D., Petrides, G., Rummans, T. A., Husain, M. M., Mueller, M., Bernstein, H. J., Knapp, R. G., O'Connor, M. K., Fink, M., Sampson, S., Bailine, S. H., & Kellner, C. H. (2010). A randomized controlled trial comparing the memory effects of continuation electroconvulsive therapy versus continuation pharmacotherapy: Results from the Consortium for Research in ECT (CORE) study. Journal of Clinical Psychiatry, 71(2), 185-193. https://doi.org/10.4088/JCP.08m04797gre