Electroconvulsive therapy does not adversely affect cognition

There appears to be no evidence of persistent cognitive impairment following electroconvulsive therapy (ECT) for depression, as reported in a study. Moreover, patients who have achieved remission seem to have improved their subjective and verbal memory recall.

Researchers conducted a secondary analysis of a trial of patients with depression who completed a randomized controlled trial of ketamine augmentation of ECT for depression. They assessed cognition using patient-rated memory and neuropsychological tests of anterograde verbal and visual memory, autobiographical memory, verbal fluency, and working memory.

Four months after completing the treatment course, 18 patients achieved remission (mean Montgomery-Asberg Depression Rating Scale [MADRS] score, 3.8, 95 percent confidence interval [CI], 2.2–5.4) and 19 patients did not (mean MADRS score, 27.2, 95 percent CI, 23.0–31.5). There were no significant baseline differences between these two groups.

At baseline, all cognitive measures were impaired in all patients. None of the parameters examined deteriorated following ECT.

Of note, at 4 months, patients who achieved remission showed improved self-rated memory, anterograde verbal memory, and category verbal fluency compared with those whose depression persisted. Self-rated memory was associated with category fluency and autobiographical memory at follow-up.

The findings suggest that self-rated memory may be used to monitor the effects of ECT on longer-term memory.