Electroconvulsive therapy is equally effective in unipolar and bipolar depression

S. Bailine, M. Fink, R. Knapp, G. Petrides, M. M. Husain, K. Rasmussen, S. Sampson, M. Mueller, S. M. McClintock, K. G. Tobias, C. H. Kellner

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81 Scopus citations


Objective: To determine the relative efficacy of electroconvulsive therapy (ECT) in the treatment of bipolar (BP) and unipolar (UP) depressive illness and clarify its role in BP depression. Method: Patients referred for ECT with both UP and BP depressions. [classified by Structured Clinical Interview for DSM (SCID-I) criteria for history of mania] were included in a multi-site collaborative, double-masked, randomized controlled trial of three electrode placements - right unilateral, bifrontal or bitemporal - in a permutated block randomization scheme. Results: Of 220 patients, 170 patients (77.3%) were classified as UP and 50 (22.7%) as BP depression in the intent-to-treat sample. The remission and response rates and numbers of ECT for both groups were equivalent. Conclusion: Both UP and BP depressions remit with ECT. Polarity is not a factor in the response rate. In this sample ECT did not precipitate mania in depressed patients. Treatment algorithms for UP and BP depression warrant re-evaluation.

Original languageEnglish
Pages (from-to)431-436
Number of pages6
JournalActa Psychiatrica Scandinavica
Issue number6
StatePublished - Jun 2010


  • Bipolar depression
  • Electroconvulsive therapy
  • Electrode placement
  • Remission rates
  • Unipolar depression


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