CoChat
Sign Up
Cited by 287Electroconvulsive Therapy StudiesTreatment of Major DepressionTranscranial Magnetic Stimulation Studies

Relapse Following Successful Electroconvulsive Therapy for Major Depression: A Meta-Analysis

Open access
Jelovac, Ana, Kolshus, Erik, McLoughlin, Declan M·2013·Neuropsychopharmacology
DOI 10.1038/npp.2013.149PMC PMC3799066
Open this paper in CoChat — free accountOpen PDF

Abstract

High rates of early relapse following electroconvulsive therapy (ECT) are typically reported in the literature. Current treatment guidelines offer little information to clinicians on the optimal nature of maintenance therapy following ECT. The aim of this study was to provide a systematic overview of the existing evidence regarding post-ECT relapse. A keyword search of electronic databases was performed for studies appearing in the peer-reviewed literature before January 2013 reporting on relapse rates in responders to an acute course of ECT administered for a major depressive episode. Meta-analyses were performed where appropriate. Thirty-two studies with up to 2 years' duration of follow-up were included. In modern era studies of continuation pharmacotherapy, 51.1% (95% CI=44.7-57.4%) of patients relapsed by 12 months following successful initial treatment with ECT, with the majority (37.7%, 95% CI=30.7-45.2%) relapsing within the first 6 months. The 6-month relapse rate was similar in patients treated with continuation ECT (37.2%, 95% CI=23.4-53.5%). In randomized controlled trials, antidepressant medication halved the risk of relapse compared with placebo in the first 6 months (risk ratio=0.49, 95% CI=0.39-0.62, p<0.0001, number needed to treat=3.3). Despite continuation therapy, the risk of relapse within the first year following ECT is substantial, with the period of greatest risk being the first 6 months. The largest evidence base for efficacy in post-ECT relapse prevention exists for tricyclic antidepressants. Published evidence is limited or non-existent for commonly used newer antidepressants or popular augmentation strategies. Maintenance of well-being following successful ECT needs to be improved.

Integrity signals

Registry

Crossref · 10.1038/npp.2013.149

Cites

36 of 36 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Numerous high-quality studies show that treatment effects wane and that the risk of relapse ranges from 29% to 51% in the first year after treatment completion.

    “However, numerous high-quality studies show that treatment effects wane and that the risk of relapse ranges from 29% to 51% in the first year after treatment completion 2-4 .”

    From ChatGPT: five priorities for research (2023) · cites this paper as [2]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Jelovac, A., Kolshus, E., & McLoughlin, D. M.
Affiliations
Trinity College Dublin (IE)
Corresponding author
McLoughlin, Declan M
ORCID
Venue
Neuropsychopharmacology
Publisher
Springer Science and Business Media LLC
Published
2013-06-18
Volume
38
Issue
12
Pages
2467-2474
ISSN
  • 0893-133X (ISSN-L)
  • 1740-634X
DOI
10.1038/npp.2013.149
PMC
PMC3799066
OpenAlex
W1997583789
Cited by
287
References
36
Citations by year
2026: 23 · 2025: 24 · 2024: 21 · 2023: 25 · 2022: 21 · 2021: 30 · 2020: 32 · 2019: 37 · 2018: 21 · 2017: 14 · 2016: 18 · 2015: 12 · 2014: 6 · 2013: 2
FWCI
1.73
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Neuropsychopharmacology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Arrow@dit (Dublin Institute of Technology) (submittedVersion, cc-by-nc-sa)
Funders
Health Research Board (TRA/2007/5)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
Keywords
electroconvulsive therapy, major depressive disorder, relapse, maintenance therapy, antidepressants, tricyclic antidepressants, relapse prevention, treatment-resistant depression
MeSH terms
Antidepressive Agents, Depressive Disorder, Major, Major Depressive Disorder, Electroconvulsive Therapy, Humans, Recurrence, Risk Factors

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review