Comparative efficacy, cognitive effects and acceptability of electroconvulsive therapies for the treatment of depression: protocol for a systematic review and network meta-analysis.

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Authors

Nikolin, Stevan
Owens, Kieran
Francis-Taylor, Rohan
Chaimani, Anna
Martin, Donel M
Bull, Michael
Sackeim, Harold A
McLoughlin, Declan M
Sienaert, Pascal
Kellner, Charles H
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Issue Date

2022-12-22

Type

Journal Article

Language

en

Keywords

Adult psychiatry , Depression & mood disorders , MENTAL HEALTH

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Abstract

There have been important advances in the use of electroconvulsive therapy (ECT) to treat major depressive episodes. These include variations to the type of stimulus the brain regions stimulated, and the stimulus parameters (eg, stimulus duration/pulse width). Our aim is to investigate ECT types using a network meta-analysis (NMA) approach and report on comparative treatment efficacy, cognitive side effects and acceptability.
We will conduct a systematic review to identify randomised controlled trials that compared two or more ECT protocols to treat depression. This will be done using the following databases: Embase, MEDLINE PubMed, Web of Science, Scopus, PsycINFO, Cochrane CENTRAL and will be supplemented by personal contacts with researchers in the field. All authors will be contacted to provide missing information. Primary outcomes will be symptom severity on a validated continuous clinician-rated scale of depression, cognitive functioning measured using anterograde verbal recall, and acceptability calculated using all-cause drop-outs. Secondary outcomes will include response and remission rates, autobiographical memory following a course of ECT, and anterograde visuospatial recall.Bayesian random effects hierarchical models will compare ECT types. Additional meta-regressions may be conducted to determine the impact of effect modifiers and patient-specific prognostic factors if sufficient data are available.
This NMA will facilitate clinician decision making and allow more sophisticated selection of ECT type according to the balance of efficacy, cognitive side effects and acceptability.
This systematic review and NMA does not require research ethics approval as it will use published aggregate data and will not collect nor disclose individually identifiable participant data.
CRD42022357098.

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Citation

Nikolin S, Owens K, Francis-Taylor R, et alComparative efficacy, cognitive effects and acceptability of electroconvulsive therapies for the treatment of depression: protocol for a systematic review and network meta-analysisBMJ Open 2022;12:e068313. doi: 10.1136/bmjopen-2022-068313

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© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Journal

BMJ open

Volume

12

Issue

12

URI

https://repository.stpatricks.ie/handle/internal/306

PubMed ID

36549738

DOI

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2044-6055

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