Several studies have reported that there is an enhancement of acetylcholinesterase during the postictal period after ECT. These medicines include cholinesterase inhibitor (e.g., donepezil and galantamine) and N-methyl-D-aspartic acid (NMDA) receptor antagonist memantine. One pharmacological approach that has been considered to mitigate adverse effects associated with ECT is the use of cognitive enhancers, agents that are often used to treat dementia. Thus, to improve therapeutic effectiveness, efforts to prevent or limit these cognitive deficits are essential. The most common adverse effects include anterograde memory impairment, transient delirium and/or retrograde memory impairment. However, ECT-induced adverse effects have been associated with a variety of transient impairments in cognitive performance and memory, leading to limited use of ECT as an effective treatment of depression, schizophrenia, mania and other conditions where it can potentially produce positive overturning effect. The use of electroconvulsive therapy (ECT) has historically been demonstrated to be a highly effective and safe treatment method of major depression and catatonic state, especially in patients refractory to pharmacotherapy. Nevertheless, more high-quality randomized controlled trials (RCTs) with long-term follow-up are still needed to make the final conclusion. This meta-analysis revealed that cognitive enhancers might improve cognitive function and reduce ECT-induced cognitive side effects. Moreover, sensitivity analysis showed that no individual study had a significant impact on the overall results. The cognitive enhancer group (CEG) had a significantly higher cognitive function score. Results:įive studies with 202 patients were included in this study. The primary outcome extracted from the studies was cognitive function score. Only studies published up to October 2019 comparing cognitive enhancer vs placebo for cognitive function after ECT were included. We identified relevant studies by searching electronic databases (e.g., PubMed, EMBASE, Web of Science, Cochrane Library). We conducted a systematic review and meta-analysis to assess the effectiveness of cognitive enhancers in the prevention of cognitive side effects due to ECT. Ĭognitive enhancers, including cholinesterase inhibitors and memantine, are used to treat dementia, but their effect for reducing post-electroconvulsive therapy (post-ECT) cognitive side effects is unclear. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website ( This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. ![]() Supplemental digital content is available for this article. Supplemental Digital Content is available for this article. ![]() ![]() The authors have no conflict of interest to disclose.Įthical approval: This article does not contain any studies with human participants or animals performed by any of the authors. Prophylactic cognitive enhancers for improvement of cognitive function in patients undergoing electroconvulsive therapy: A systematic review and meta-analysis. How to cite this article: Niu Y, Ye D, You Y, Wu J. ∗Correspondence: Yijie You, Department of Neurosurgery (e-mail: ) Jian Wu, Department of Neurology, The First People's Hospital of Changzhou, #185 Juqian Road, Changzhou, Jiangsu, China (e-mail: ).Ībbreviations: 3MS = Modified Mental Status Examination, CEG = Cognitive enhancer group, CI = confidence interval, ECT = electroconvulsive therapy, MMSE = Mini-Mental State Examination, NMDA = N-methyl-D-aspartic acid, PG = placebo group, post-ECT = post-electroconvulsive therapy, RBANS = Repeatable Battery for the Assessment of Neuro-psychological Status, RCTs = randomized controlled trials, SMD = standard mean difference. ADepartment of Neurology, The First People's Hospital of ChangzhouīDepartment of Neurology, The Third Affiliated Hospital of Soochow UniversityĬDepartment of Neurosurgery, The First People's Hospital of ChangzhouĭDepartment of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.
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