Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
John Cavenagh, MBA, PhD, PA-C
OBJECTIVE: The objective of this selective EBM review is to determine whether or not bitemporal ECT is more effective than bifrontal ECT in the treatment of adults with major depressive disorder. STUDY DESIGN: Review of three published randomized controlled trials, all English language. All RCTs were published after 1999 and studied patients older than 17 years old. DATA SOURCES: Three randomized control trials were found using PubMED, OVID, and Medline. Articles were selected based on relevance and that the outcomes of the studies mattered to patients. OUTCOME(S) MEASURED: Hamilton Rating Scale for Depression- 24 item completed by practitioner. RESULTS: The results of the Kellner6 study was that bitemporal ECT placement had an average change in HRSD-24 score of 22.4 points, from 33.7 to 11.3 (P<0.0001), and a remission rate of 64% (95% CI 53-75%). Bitemporal ECT was 3% more effective than bifrontal ECT for treating depression. 6 The Bailine2 study concluded that bitemporal ECT placement had an average change in HRSD-24 score of 22.7 points, from 27.7 to 5.0 and a remission rate of 95.8%. Bifrontal ECT was 4.2% more effective than bitemporal ECT for treating depression. 2 The Ranjkesh8 study reported that bitemporal ECT placement had an average change in HRSD-24 score of 24.3 points, from 32.1 to 7.8, and a remission rate of 100%. There was no difference in effectiveness when comparing bitemporal ECT to bifrontal ECT.8 CONCLUSIONS: The results of the three randomized controlled trials found that bitemporal ECT and bifrontal ECT are effective in the treatment of adults with major depressive disorder. The analysis of the three randomized controlled trials is inconclusive to whether bitemporal is more effective than bifrontal ECT in treating adults with major depressive disorder.
Brinton, Talia M., "Is bitemporal ECT more effective than bifrontal ECT in reducingthe symptoms of depression in adults?" (2015). PCOM Physician Assistant Studies Student Scholarship. 211.