A comparison of brief and ultrabrief pulse stimuli in unilateral ECT

A double-blind randomized, comparative study of the therapeutic efficacy an d side effects of unilateral electroconvulsive therapy (ECT) given with two different stimulus types was carried out in the Kuffner Sanatorium, Horni Berkovice, Czech Republic. Brief or ultrabrief pulse stimuli were used in 4 8 hospitalized patients, ages 17-61 years, diagnosed with either schizophre nia (n = 42) or major depression (n = 6). All patients received eight unila teral treatments each. Their clinical state and presence of cognitive impai rment were evaluated with a battery of tests and rating scales before ECT, after the last ECT, and 1 month later. Patients were markedly improved afte r the course of ECT, and the improvement was maintained 1 month later. Ther e were no significant, differences in the extent of improvement between the groups treated with brief- and ultrabrief-pulse stimuli. No deleterious ef fects on cognitive functions and memory were detected. In fact, there was a trend toward improvement in memory and other cognitive functions after ECT in both groups, with no significant difference between them. The two stimu lus waveforms studied (brief and ultrabrief pulse) thus appear to be equall y effective and free of deleterious effects on memory and cognition. The re sponse in schizophrenic patients was remarkable and deserving of further st udy.