This is Depressing

A study by Kellner et al. in the December Archives of General Psychiatry examined long-term (okay, only six months, but that’s what goes for long-term in mental health outcomes research) outcomes for depressed patients. The patients in the study all experienced remission of their depression symptoms while receiving electroconvulsive therapy (ECT). Some patients then received continuing ECT treatments (C-ECT group) whereas others received a combination of lithium and nortriptyline (a tricyclic antidepressant; C-Pharm group). The follow-up period lasted for six months.

To summarize the results, I’ll quote from the abstract: “In the C-ECT group, 37.1% experienced disease relapse, 46.1% continued to have disease remission at the study end, and 16.8% dropped out of the study. In the C-Pharm group, 31.6% experienced disease relapse, 46.3% continued to have disease remission, and 22.1% dropped out of the study… Mean ± SD time to relapse for the C-ECT group was 9.1 ± 7.0 weeks compared with 6.7 ± 4.6 weeks for the C-Pharm group (P = .13). Both groups had relapse proportions significantly lower than a historical placebo control from a similarly designed study.”

So what they’re saying is that the average depressed person could not eke out two months without depressive relapse on meds and could barely squeeze out two months on ECT. That is far from impressive. In both groups, over half of patients dropped out of the study or had their depressive symptoms return. As I’ve mentioned before, it would make much more sense to just stick with the data, which indicate significantly better long-term outcomes for depression when psychotherapy is used as opposed to medication, or, apparently ECT.