Patterns of psychotropic medication use among patients with severe depression referred for electroconvulsive therapy: Data from the consortium for research on electroconvulsive therapy

Keith G. Rasmussen, Martina Mueller, Charles H. Kellner, Rebecca G. Knapp, George Petrides, Teresa A. Rummans, Mustafa M. Husain, M. Kevin O'Connor, John L. Black, Shirlene Sampson, Max Fink

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Most studies of trends in antidepressant pharmacotherapy have focused on relatively mildly ill, nonpyschotic outpatients. In this report, we provide detailed information on psychotropic use among patients with unipolar depression participating in a large, multisite electroconculsive therapy (ECT) study. Adequacy of antidepressant medication trials was assessed with the Antidepressant Treatment History Form. Among patients with nonpsychotic depression, 27% (60/220) had not had an adequate trial of an antidepressant before ECT, and 63% (139/220) had had at least one inadequate trial. Surprisingly, 33% (79/243) of nonpsychotic patients had been prescribed an antipsychotic. Among patients with psychotic depression, 95% (101/106) had not been given an adequate combination of an antidepressant and antipsychotic agent, mostly due to low doses of the latter class. Among all patients in the trial, 61% (213/352) had been prescribed at least one benzodiazepine, and only 7% (24/352) had been given a lithium augmentation trial. Use of hypnotic agents and anticonvulsants was common. In conclusion, patients with severe depression referred for ECT with a unipolar depressive episode have high rates of psychotropic usage, much of which is inadequate.

Original languageEnglish (US)
Pages (from-to)116-123
Number of pages8
JournalJournal of ECT
Volume22
Issue number2
DOIs
StatePublished - Jun 1 2006

Keywords

  • Depression
  • Electroconvulsive therapy
  • Medication resistance

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Psychiatry and Mental health

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