Mortality in Depressed Patients Treated With Electroconvulsive Therapy and Antidepressants

TLDR

A three‑year follow‑up compared mortality among 519 hospitalized depressed patients receiving electroconvulsive therapy, adequate antidepressants, or no treatment. Patients receiving ECT had significantly lower mortality than those with inadequate antidepressants or no treatment, and although adequate antidepressants also lowered mortality, differences were not statistically significant; nonsuicidal deaths, particularly myocardial infarctions, were more common in inadequately treated patients, with the greatest benefit seen in older men, highlighting the importance of adequate depression treatment.

Abstract

• The treatments of 519 depressed patients hospitalized from 1959 to 1969 were compared in a three-year follow-up study with particular reference to mortality. The electroconvulsive therapy (ECT) group had a significantly lower mortality than the inadequate antidepressant treatment group (<i>P</i>&lt;.05) and the group that received neither ECT nor antidepressants (<i>P</i>&lt;.025). Although the adequate antidepressant treatment group had a low mortality, statistically significant differences between this and other treatment groups could not be documented. Nonsuicidal deaths (<i>P</i>&lt;.005), and particularly myocardial infarctions (<i>P</i>&lt;.01), were significantly more frequent in the inadequately treated group compared to the adequately treated group. The superiority of adequate treatment is especially striking among men and among the older age groups. The results underscore the importance of adequate treatment of depression, especially in the older man.