Original ArticleEfficacy of ECT in Depression: A Meta-Analytic ReviewPagnin, Daniel MD, MSc; de Queiroz, Valéria MD, MSc; Pini, Stefano MD; Cassano, Giovanni Battista MD Author Information From the Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology. University of Pisa, Italy Received for publication August 20, 2003; accepted November 17, 2003. Reprints: Dr. Daniel Pagnin, Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, Via Roma, 67–56100. Pisa, Italy (e-mail: [email protected]). The Journal of ECT 20(1):p 13-20, March 2004. Buy Abstract Summary: This study analyzed the efficacy of electroconvulsive therapy (ECT) in depression by means a meta-analytic review of randomized controlled trials that compared ECT with simulated ECT or placebo or antidepressant drugs and by a complementary meta-analytic review of nonrandomized controlled trials that compared ECT with antidepressants drugs. The review revealed a significant superiority of ECT in all comparisons: ECT versus simulated ECT, ECT versus placebo, ECT versus antidepressants in general, ECT versus TCAs and ECT versus MAOIs. The nonrandomized controlled trials also revealed a significant statistical difference in favor of ECT when confronted with antidepressants drugs. Data analyzed suggest that ECT is a valid therapeutic tool for treatment of depression, including severe and resistant forms. © 2004 Lippincott Williams & Wilkins, Inc.