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Efficacy of ECT in Depression: A Meta-Analytic Review

Pagnin, Daniel MD, MSc; de Queiroz, Valéria MD, MSc; Pini, Stefano MD; Cassano, Giovanni Battista MD

Original Article

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.

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:

© 2004 Lippincott Williams & Wilkins, Inc.