Shock therapy safe, effective for tough-to-treat depression
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"Shock"- electroconvulsive therapy often helps lift severe depression, but fear and stigma can deter patients from getting it. Now a large new study is confirming the treatment's safety.

This study aimed to compare the risk of serious medical events, defined as those resulting in hospitalization or death, among patients with depression who received electroconvulsive therapy versus patients who did not receive electroconvulsive therapy.

Electroconvulsive therapy exposure was defined as one or more physician billing procedure codes during hospitalization. The primary outcome was serious medical events, a composite of hospitalization for medical reasons or non-suicide death within 30 days from electroconvulsive therapy exposure or matched date in the unexposed group. Effect modification was examined using tests of interaction for three clinically relevant prespecified subgroups. Secondary outcomes were medical hospitalization and non-suicide death separately, suicide death, and specific serious medical events.

- In the propensity score-matched cohort, the incidence of serious medical events was 0·25 per person-year in the exposed group and 0·33 per person-year in the unexposed group.

- Suicide death as a competing risk did not alter this finding. The risk of suicide death was significantly lower in the exposed versus the unexposed group.

- Bipolar depression, compared with unipolar depression, was associated with a greater reduction in the risk of serious medical events with electroconvulsive therapy.

- Electroconvulsive therapy was not associated with medical hospitalization or non-suicide death separately, nor with any specific serious medical event.

Among individuals hospitalized with depression, no evidence for a clinically significant increased risk for serious medical events was found with exposure to electroconvulsive therapy, and the risk of suicide was found to be significantly reduced.

The Lancet Psychiatry
Source: https://doi.org/10.1016/S2215-0366(21)00168-1
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