Abstract
Objective
To systematically evaluate the efficacy of electroconvulsive therapy (ECT) combined with antidepressant medication in patients with treatment-resistant depression.
Methods
A search of the CNKI, Wanfang, Vip, China Biomedical Literature Database, PubMed, Cochrane Library, Embase, and Web of Science databases was conducted from their inception to January 1, 2025. Randomized controlled trials evaluating the efficacy of ECT combined with antidepressant medication in patients with treatment resistant depression were included. The experimental group received ECT combined with antidepressant drugs, while the control group received either ECT alone or ECT combined with a placebo. Data were analyzed using RevMan 5.2 software.
Results
A total of 11 randomized controlled trials involving 1254 patients were included in the analysis. Patients treated with ECT combined with antidepressants showed significantly greater improvement in depressive symptoms (SMD = 0.29, 95% CI = 0.47 to 0.12, P = 0.001) and higher remission rates (OR = 1.73, 95% CI = 1.24 to 2.40, P = 0. 001) compared to patients treated with ECT alone. There was no significant difference between the two groups in seizure duration (SMD = 0.17, 95% CI = 0.14 to 0.49, P = 0.28) or the incidence of adverse effects (OR = 1.15, 95% CI = 0.73 to 21.82, P = 0.54).
Conclusion
The combination of ECT and antidepressant medication modestly improves depressive symptoms and increases remission rates in patients with treatment resistant depression. Additionally, there is no significant difference in seizure duration or the incidence of adverse reactions compared to ECT alone, suggesting a comparable safety profile.
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