A Global Delphi-Based Expert Consensus on Relapse Prevention Strategies Following Successful Electroconvulsive Therapy for Major Depressive Disorder - PubMed
12 hours ago
- #Electroconvulsive Therapy
- #Delphi Consensus
- #Depression Relapse
- 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.