Comparison of Antidepressant Effects Between Brief and Ultrabrief Pulse Unilateral Electroconvulsive Therapy Brief Report of a Randomized Double-Blind Trial

Objective: Electroconvulsive therapy (ECT) treatments with briefer pulse widths have recently shown promise. Methods: Consenting patients with major depression were randomized in a double-blind protocol into 1-millisecond brief pulse (n = 10) or 0.3-millisecond ultrabrief pulse (n = 12) right unilateral at thrice-weekly, 6 times the threshold dose treatments at identical charge rates. Results: After 8 treatments, the change from baseline in Montgomery-Asberg Depression Scale was mean = 22.1 (SE, 4.8) for brief pulse and mean = 24.9 (SE, 4.2) for ultrabrief pulse ECT. The mean difference was 2.8 (95% confidence interval = -10.5 to 16.1; P = 0.7). Conclusions: Although inconclusive because of small sample size (type II error), ultrashort pulse widths appear to be as effective as standard pulse ECT.