Electroconvulsive Therapy for Depression

(PRESTO Trial)

This trial explores ways to improve electroconvulsive therapy (ECT) for treating depression. Researchers aim to find the best ECT settings by studying brain responses, including seizures and a new brain event called cortical spreading depolarization (CSD). Participants receive different ECT settings and are monitored to assess the effects on their brains and symptoms. This trial is open to individuals already receiving ECT at Pennsylvania Hospital who can participate in additional monitoring during their treatment. As an unphased trial, it offers a unique opportunity to advance ECT treatment methods.

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial team or your doctor.

Research shows that electroconvulsive therapy (ECT) is generally a safe treatment for depression and proves effective, especially when other treatments have failed. Patients often tolerate ECT well, and it has been in use for many years.

In the "Frequency-then-Duration" approach, research indicates that ECT is a low-risk procedure that helps treat depression, suicidal thoughts, and severe mental illness. Some side effects, like temporary memory loss, can occur, but they are usually mild and short-lived.

With the "Duration-then-Frequency" method, ECT also maintains a strong safety record. Some studies suggest it might cause slightly more confusion or memory problems at higher electric levels, but these effects are generally mild and temporary.

Most treatments for depression, like medications and psychotherapy, can take weeks to show results. Electroconvulsive Therapy (ECT) is unique because it can provide relief much faster, often within days. Researchers are excited about exploring different ECT protocols because they may improve how effectively and safely ECT works. By experimenting with variations in the frequency and duration of ECT sessions, the trial aims to optimize its benefits and reduce side effects, potentially offering a more tailored and efficient treatment for individuals with depression.

Research has shown that Electroconvulsive Therapy (ECT) effectively treats depression. For instance, it helps 73% of people with moderate to severe depression feel better, and 51% experience complete relief from their symptoms. In another large study, 68% of patients reported feeling "much improved" or "very much improved" after ECT. This treatment also quickly reduces suicidal thoughts, with over 60% of patients feeling better within two weeks. Overall, ECT often outperforms medication for severe depression and can rapidly improve symptoms. Participants in this trial will receive assignments to different ECT treatment arms, including variations in titration methods and maintenance protocols, to evaluate the effectiveness of these approaches.⁶⁷⁸⁹¹⁰