A meta-analysis of electroconvulsive therapy efficacy in depression
Abstract
SUMMARY: Recently published controlled studies comparing electroconvulsive therapy (ECT) with other treatments for depression offer the opportunity to perform a meta-analysis of ECT in depression. Fifteen studies were identified which fulfilled the inclusion criteria. From these controlled trials, 20 effect sizes of ECT were calculated. The speed of action during the course and the efficacy after a full course of ECT were explored. The efficacy of sine wave and brief pulse machines were compared. The comparison between ECT and four other comparative treatments was made. Predictive variables were explored using homogeneity tests. ECT was shown to be superior after a full course. The funnel plot showed the absence of publication bias. There was no exaggeration of effect size in the lower quality trials. No evidence was found for a superior speed of action of ECT or for a difference in efficacy between sine wave and brief pulse stimulation. ECT was shown to be superior to medication and simulated ECT. Some evidence was found that psychosis predicted better response to ECT.
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Electroconvulsive therapy (ECT) has been shown to be one of the most effective treatments for TRD.
“Electroconvulsive therapy (ECT) has been shown to be one of the most effective treatments for TRD (Kho et al., 2003;Lisanby, 2007).”
From Neurocognitive effects of theta burst stimulation for treatment-resistant depression in adults: A systematic review and recommendations for future research (2025) · cites this paper as Kho et al., 2003
Cites
Moher, D., Pham, B., Jones, A., Cook, D. J., Jadad, A. R., Moher, M., Tugwell, P., & Klassen, T. P. (1998) · The Lancet · doi:10.1016/s0140-6736(98)01085-x · Cited by 3,560 · see citing works
Langer, G., Karazman, R., Neumark, J., Saletu, B., Schönbeck, G., Grünberger, J., Dittrich, R., Petricek, W., Hoffmann, P., Linzmayer, L., et al. (2008) · Neuropsychobiology · doi:10.1159/000119190 · Cited by 59 · see citing works
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Joshi, S. H., Espinoza, R. T., Pirnia, T., Shi, J., Wang, Y., Ayers, B., Leaver, A., Woods, R. P., & Narr, K. L. (2016) · Biological Psychiatry · doi:10.1016/j.biopsych.2015.02.029 · Cited by 320 · see citing works
Fettes, P., Schulze, L., & Downar, J. (2017) · Frontiers in Systems Neuroscience · doi:10.3389/fnsys.2017.00025 · Cited by 299 · see citing works
Electroconvulsive Therapy Stimulus Parameters: Rethinking Dosage
Peterchev, A. V., Rosa, M. A., Deng, Z.-D., Prudic, J., & Lisanby, S. H. (2010) · The Journal of ECT · doi:10.1097/yct.0b013e3181e48165 · Cited by 213 · see citing works
Machado-Vieira, R., Salvadore, G., Luckenbaugh, D. A., Manji, H. K., & Zarate, C. A. (2008) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v69n0610 · Cited by 195 · see citing works
Perugi, G., Medda, P., Toni, C., Mariani, M., Socci, C., & Mauri, M. (2017) · Current Neuropharmacology · doi:10.2174/1570159x14666161017233642 · Cited by 167 · see citing works
Key updates in the clinical application of electroconvulsive therapy
Weiner, R. D., & Reti, I. M. (2017) · International Review of Psychiatry · doi:10.1080/09540261.2017.1309362 · Cited by 166 · see citing works
Dierickx, S., Deliens, L., Cohen, J., & Chambaere, K. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1369-0 · Cited by 129 · see citing works
A comparison of RUL ultrabrief pulse (0.3 ms) ECT and standard RUL ECT
Loo, C. K., Sainsbury, K., Sheehan, P., & Lyndon, B. (2008) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145708009292 · Cited by 127 · see citing works
Pirnia, T., Joshi, S. H., Leaver, A. M., Vasavada, M., Njau, S., Woods, R. P., Espinoza, R., & Narr, K. L. (2016) · Translational Psychiatry · doi:10.1038/tp.2016.102 · Cited by 122 · see citing works
Bouckaert, F., De Winter, F.-L., Emsell, L., Dols, A., Rhebergen, D., Wampers, M., Sunaert, S., Stek, M., Sienaert, P., & Vandenbulcke, M. (2016) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.140322 · Cited by 115 · see citing works
Vasavada, M. M., Leaver, A. M., Njau, S., Joshi, S. H., Ercoli, L., Hellemann, G., Narr, K. L., & Espinoza, R. (2017) · The Journal of ECT · doi:10.1097/yct.0000000000000426 · Cited by 73 · see citing works
Nuninga, J. O., Claessens, T. F. I., Somers, M., Mandl, R., Nieuwdorp, W., Boks, M. P., Bakker, S., Begemann, M. J. H., Heringa, S., & Sommer, I. E. C. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.06.040 · Cited by 56 · see citing works
Li, D.-J., Wang, F.-C., Chu, C.-S., Chen, T.-Y., Tang, C.-H., Yang, W.-C., Chow, P. C.-K., Wu, C.-K., Tseng, P.-T., & Lin, P.-Y. (2017) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2016.11.008 · Cited by 51 · see citing works
Electroconvulsive therapy—efficacy and side-effects
Moksnes, K. M., & Ilner, S. O. (2010) · Tidsskrift for Den norske legeforening · doi:10.4045/tidsskr.09.1102 · Cited by 20 · see citing works
Hutnyan, M., & McClintock, S. M. (2025) · Transcranial Magnetic Stimulation · doi:10.1016/j.transm.2025.100088 · Cited by 2 · see citing works
- Authors
- Kho, K. H., van Vreeswijk, M. F., Simpson, S., & Zwinderman, A. H.
- Affiliations
- GGZ Delfland (NL)
- Amsterdam UMC Location University of Amsterdam (NL)
- Corresponding author
- Kho, King Han
- Venue
- The Journal of ECT
- Published
- 2003-09
- Volume
- 19
- Issue
- 3
- Pages
- 139-147
- ISSN
- 1095-0680 (ISSN-L)
- OpenAlex
- W2027570863
- Cited by
- 265
- References
- 2
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 10 · 2023: 13 · 2022: 13 · 2021: 22 · 2020: 15 · 2019: 21 · 2018: 11 · 2017: 14 · 2016: 14 · 2015: 11 · 2014: 10 · 2013: 6 · 2012: 10
- FWCI
- 1.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Ect (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- 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, depression, treatment efficacy, speed of action, publication bias
- MeSH terms
- Depressive Disorder, Electroconvulsive Therapy, Humans, Time Factors, Randomized Controlled Trials as Topic, Treatment Outcome
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