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The response rate for low-dose unilateral electroconvulsive therapy was 17 percent,as compared with 43 percent for high-dose unilateral therapy(P=0. 054),65 percent for low-dose bilateral therapy(P=0.001),and 63 percent for high-dose bilateral therapy(P=0.001).Regardless of electrode placement, high dosage resulted in more rapid improvement(P<0.05).Compared with the low-dose unilateral group,the high-dose unilateral group took 83 percent longer(P<0.001)to recover orientation after seizure induction,whereas the combined bilateral groups took 252 percent longer(P<0.001).During the week after treatment,there was three times more retrograde amnesia about personal information with bilateral therapy(P<0.001).There were no differences between treatment groups in cognitive effects two months after treatment.Forty-one of the 70 patients who responded to therapy(59 percent)relapsed,and there were no differences between treatment groups. Increasing the electrical dosage increases the efficacy of right unilateral electroconvulsive therapy,although not to the level of bilateral therapy.High electrical dosage is associated with a more rapid response,and unilateral treatment is associated with less severe cognitive side effects after treatment. |
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