Ultrabrief pulse electroconvulsive therapy for depression: a systematic review and meta-analysis

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Abstract
Ultrabrief pulse (k = 23, n = 1478) was 32.2% (95% CI 26.1%-39.0%) with ultrabrief pulse high-dose right unilateral ECT. Less than half of patients (45.3% [95% CI 39.0%-51.7%]) treated with this form of ECT achieved therapeutic response. Switching to brief-pulse ECT due to perceived inadequate response was common and occurred in 28.1% of patients (95% CI 20.6%-37.0%). Of remitters with ultrabrief pulse high-dose right unilateral ECT treated with continuation pharmacotherapy, 44.1% (95% CI 34.4%-54.3%) relapsed or withdrew within six months of completion of an acute course of ECT. The results of this meta-analysis indicate that acute outcomes following ultrabrief pulse ECT fall short of those expected with conventional brief-pulse ECT. As such, ultrabrief pulse ECT cannot be regarded as “state-of-the-art” ECT.

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