The Effectiveness of Maintenance Electroconvulsive Therapy

Abstract

Introduction: Electroconvulsive therapy (ECT) is a safe and effective treatment for treatment resistant severe mental disorders. However, it has a high relapse rate, following the acute course (A‑ECT). Maintenance treatment is recommended to increase remission rate and duration. Maintenance ECT (M‑ECT) is an option, although under‑prescribed. The aim of this study was to assess M‑ECT effectiveness in reducing number and duration of hospital admissions, as well as associated costs, in patients with severe mental disorders. Mirror study comparing number and duration of hospital admissions before and after first M‑ECT. Methods: Information was gathered for demographic and technical data, and drug dosing. Mean cost before and after the initiation of M‑ECT was compared. All treatments were performed with a MECTA spECTrum 5000QÒ. Statistical analysis was performed using SPSS 22. Results: A total of 16 patients were enrolled. The mean number of M‑ECT treatments was 41.25 with a mean duration of 23 months. Treatment frequency was mainly once a month. A statistically significant decrease was found for number of admissions (Mdn=2.0 before and Mdn=0.0 after) and for total days in admission (Mdn=86.0 before and Mdn=14.5 after). Marginally significant results were found for antidepressive dosage, with higher dosages in the after initiation period. No significant results were found for antipsychotic dosage variation. The mean cost per patient, before and after initiation of M‑ECT, was respectively 10 621€ and 5 653€. Conclusão: In our sample, we found that M‑ECT significantly reduces number of admissions and days in admission. Initiating M‑ECT treatment decreased cost per patient by 47%.