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Neuroendocrine and clinical effects of electroconvulsive therapy and their relationship to treatment outcome

Published online by Cambridge University Press:  09 July 2009

J. Smith ,
K. Williams ,
S. Birkett ,
H. Nicholson ,
P. Glue  and
D. J. Nutt
J. Smith*
Affiliation:
Fromeside Clinic, Bristol; Stonebow Unit, Hereford County Hospital, Department of Anatomy and the Psychopharmacology Unit, University of Bristol
K. Williams
Affiliation:
Fromeside Clinic, Bristol; Stonebow Unit, Hereford County Hospital, Department of Anatomy and the Psychopharmacology Unit, University of Bristol
S. Birkett
Affiliation:
Fromeside Clinic, Bristol; Stonebow Unit, Hereford County Hospital, Department of Anatomy and the Psychopharmacology Unit, University of Bristol
H. Nicholson
Affiliation:
Fromeside Clinic, Bristol; Stonebow Unit, Hereford County Hospital, Department of Anatomy and the Psychopharmacology Unit, University of Bristol
P. Glue
Affiliation:
Fromeside Clinic, Bristol; Stonebow Unit, Hereford County Hospital, Department of Anatomy and the Psychopharmacology Unit, University of Bristol
D. J. Nutt
Affiliation:
Fromeside Clinic, Bristol; Stonebow Unit, Hereford County Hospital, Department of Anatomy and the Psychopharmacology Unit, University of Bristol
*
1Address for correspondence: Dr Jeanette Smith, Fromeside Clinic, Blackberry Hill, Stapleton, Bristol BS16 1ED
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Synopsis

Two groups of variables, endocrine and clinical, have been reported to have predictive value in determining response to electroconvulsive therapy (ECT) in depressed patients. Baseline levels of oxytocin associated neurophysin (OAN) and peak OAN response to ECT may predict clinical outcome, while the presence of delusional symptoms may indicate favourable initial response to ECT. The purpose of this study was to examine the relationship between these variables on initial and longer term response over a course of ECT, using a direct measure of plasma oxytocin concentrations. A substantial and immediate increase in oxytocin was seen after the first ECT, with significantly attenuated responses after the third and fifth ECTs. Increased plasma vasopressin concentrations were seen after all ECT treatments, each response being of similar magnitude. No associations were found between either endocrine baseline levels or peak responses, and clinical outcome. Only clinical variables predicted outcome, as patients with psychotic symptoms had more rapid initial response to ECT, and patients who had relapsed 2 months after the end of ECT had significantly higher depression ratings at day 14 of treatment than treatment responders.

Type
Original Articles
Information
Psychological Medicine , Volume 24 , Issue 3 , August 1994 , pp. 547 - 555
Copyright
Copyright © Cambridge University Press 1994

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