ISOFLURANE NARCOTHERAPY IN DEPRESSIVE PATIENTS REFRACTORY TO CONVENTIONAL ANTIDEPRESSANT DRUG-TREATMENT - A DOUBLE-BLIND COMPARISON WITH ELECTROCONVULSIVE TREATMENT

This is the first report on a controlled study comparing the therapeut ic and non-therapeutic (side) effects of electroconvulsive treatment ( ECT) and isoflurane narcotherapy (ISONAR; deep anesthesias with the in halation of anesthetic isoflurane) in drug-refractory, severely depres sed women, who had been randomly allocated either to ECT (n = 10) or I SONAR (n = 10). Patients from each group were subjected to a total of six treatment sessions (two sessions per week) and maintained on a fix ed antidepressant drug dose. The antidepressant efficacy of either tre atment was evaluated for each treatment session (in search of a 'rapid antidepressant effect') and at weekly intervals. Cognitive functions or signs of an organic brain syndrome were evaluated by means of psych ological tests and extensive EEG analyses. Rapid antidepressant effect s of the first treatment session were only significant in patients on ISONAR; in the subsequent treatment sessions, ECT also induced rapid a ntidepressant effects. Antidepressant effects during the treatment per iod were comparable, and patients on ISONAR improved further during fo llow-up, whereas patients on ECT tended to relapse. ISONAR-treated pat ients improved in most psychometric variables, whereas patients on ECT deteriorated. Finally, the EEG patterns of the ISONAR-treated patient s remained normal or augmented (dominant alpha power), whereas patient s on ECT developed an increase in abnormalities in EEG patterns and th eta/delta power. This indicates an organic brain syndrome in patients on ECT.