Sammanfattning
Background. In electroconvulsive therapy (ECT) there is uncertainty regarding the degree of effect and the duration of side-effects. We wanted to investigate indications, efficacy, time to response, and side-effects.
Material and method. A systematic examination was made of ECT protocols and case records from three psychiatric departments at Dikemark Hospital during the period 1960 - 95.
Results. 141 individuals received 241 courses of treatment and a total of 1 960 treatments. The main diagnosis was major depression in 124 patients (88 %). Before ECT, 129 (91 %) had been treated with at least one antidepressant, 107 (76 %) with at least two different antidepressants, and 67 (48 %) were treated with drugs from two different classes, without satisfactory clinical improvement of the relevant episode of depression. Lithium was used in advance by 31 (22 %). Within four weeks after the first ECT, the condition was assessed as improved in 120 patients (85 %). Remission occurred in 61, and these could be discharged within four weeks. The first signs of improvement after the first course were noted in 92 patients, and 71 (77 %) showed improvement within six days. Side-effects were registered after 123 of a total of 241 courses (51 %). Five patients developed serious complications.
Interpretation. The immediate effect of ECT was good, and signs of improvement appeared in most cases during the first week. The best response tended to occur in elderly patients with psychotic depression. Considering the extremely severe and long-lasting disease in these patients, the treatment was relatively safe and was well tolerated.