Comparison of Efficacy and Cognitive Side effect Profile between Right unilateral and Bilateral Ultra Brief Pulse ECT

BACKGROUND-: ECT is often chosen as an augmenting agent in the treatment of Schizophrenia. However, cognitive impairment is a common side-effect. It has been seen that shortening the pulse width and use of Unilateral ECT results in lesser cognitive impairment than conventional Bilateral ECT. However Ultra Brief Pulse Unilateral ECT in Schizophrenia patients are scarce. OBJECTIVES-: 1. To Compare the Efficacy of Right Unilateral Ultra Brief Pulse ECT with Bilateral Ultra Brief Pulse ECT as measured by PANSS, CGI-S scales. 2. To Compare the Neuroplastic effect of Right Unilateral Ultra Brief Pulse ECT with Bilateral Ultra Brief Pulse ECT as measured by change in Serum BDNF level 3. To Compare the Cognitive Side effect profile of Right Unilateral and Bilateral Ultra Brief Pulse ECT as measured by B4ECT-ReCoDe questionnaire METHODS-: In-patients in a tertiary care centre with a diagnosis of Schizophrenia as per ICD-10 criteria who were advised ECT were randomly matched and assigned to Bilateral and Unilateral ECT groups. Efficacy & cognitive side effect profiles were compared over the study duration between the groups. RESULTS-: 20 patients were assigned in the Right Unilateral Ultra-Brief Pulse ECT group and 40 in the Bilateral group. Although there was significant change in CGI and PANSS Score over the treatment duration but there was no statistically significant difference in treatment efficacy as per CGI scoring (p-value=0.457) and PANSS total scoring (p-value=0. 0.424). Change in Serum BDNF value was significant over the treatment duration (p-value<0.05) but not statistically significant between two groups (p-value=0.196). Cognitive impairment was significantly more in Bilateral Ultra-brief Pulse ECT group in overall Objective Scale (p-value<0.05). CONCLUSION-: Considering the better cognitive side effect profile with equal efficacy, Right Unilateral ECT can be useful in management of Schizophrenia.