A Global Delphi-Based Expert Consensus on Relapse Prevention Strategies Following Successful Electroconvulsive Therapy for Major Depressive Disorder - PubMed

14 hours ago

Electroconvulsive therapy (ECT) is highly effective for depression but has high relapse rates (up to 50% within a year).
A Delphi study with 18 global ECT experts aimed to establish consensus on relapse prevention strategies post-ECT.
Key clinical factors influencing relapse prevention include treatment resistance, psychiatric comorbidities, and prior ECT response.
Pharmacotherapy with lithium and an antidepressant (e.g., tricyclic, venlafaxine, or prior effective antidepressant) was endorsed as essential for all patients.
Continuation ECT with tapering (not abrupt cessation) is recommended for high-risk patients, especially those with severe or psychotic depression.
Psychotherapy is beneficial as an adjunctive treatment but not as a standalone strategy.
No consensus was reached on repetitive transcranial magnetic stimulation, esketamine, or optimal treatment duration beyond 6 months.
Personalized adjustments based on clinical risk factors are essential for relapse prevention.
Further empirical research is needed to refine guidelines and improve long-term outcomes.

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