The CARE-Dep Study

Logo of the CARE-Dep Study which aims to predict a good therapeutic response to electroconvulsive therapy (ECT).

The CARE-Dep Study aims to identify clinical characteristics that may predict a good therapeutic response to electroconvulsive therapy (ECT).

Depression is a major public health challenge and a leading cause of disability worldwide. In Ireland, 6,000 people are hospitalised for depression each year.

Although there are several effective treatment options available for depression - including brain stimulation techniques, antidepressant pharmacotherapy and psychotherapy - a third of people treated for depression do not respond to sequential trials of antidepressants. This state has been variously referred to as “treatment-resistant depression” or “difficult-to-treat depression” and is a topic of growing scientific and clinical interest.

While antidepressant medication is currently the mainstay of depression treatment, ECT remains the most effective treatment for depression. In Ireland and other Western countries, the majority of people referred for ECT have not responded to one or more adequate courses of antidepressant medication and can therefore be said to be treatment-resistant. Despite this, over half of all people referred for ECT go on to achieve a full remission.

Nonetheless, some previous studies have found that medication resistance is linked with a reduced response to ECT. In addition to medication resistance, several other clinical predictors of ECT response have been identified in meta-analyses of previous research, including episode duration, older age and presence of psychotic features.

The purpose of the CARE-Dep study is to identify patient or illness characteristics that may predict a good therapeutic response to ECT. This could help to better predict in advance who is more likely to benefit from this treatment, so that it can be delivered in a more optimised, personalised way.

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KARMA-DEP (2) Trial