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Preventing Relapse After Successful ECT for Depression– Arandomized controlled trial on lithium as add-on to personalizedmaintenance ECT.
Although electroconvulsive therapy (ECT) is an effective treatment for depression, preventingrelapse after successful ECT remains a major challenge. In the PRASED-study, a large multicentreRCT, we evaluate the effectiveness of three strategies to reduce relapse: an algorithm-basedsymptom-driven form of maintenance-ECT (M-ECT), with antidepressants, with or without lithium.In the four treatment centers, patients that are referred for ECT for depression will be screenedfor eligibility. In phase 1 300 patients are treated with an acute course of brief pulse ECT,combined with open label nortriptyline or venlafaxine. Patients that achieve remission, areconsidered eligible for phase 2 of the study. In this continuation phase, open label antidepressantsare continued and algorithm-based, symptom-driven M-ECT is started for the next six months.Patients will be randomized to receive either lithium or not. After six months, patients enterphase 3, a naturalistic follow-up of mood at 3 and 6 months after completion of phase 2.The combination of antidepressants, personalized M-ECT and lithium has been studied in anelderly population and proved to be very effective, but the efficacy in a severely depressedpopulation of all ages has never been assessed. This project holds great promise for reducingrelapse rates after successful ECT, thereby being of potential impact for a vulnerable group ofpatients with an often recurring and debilitating major depressive disorder. Apart from asignificant positive medical impact, reducing relapse rates eventually also has a socio-economicimpact by reducing health care costs.
Date:15 Jan 2019 → Today