Electroconvulsive therapy (ECT)

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The 2019 RANZCP clinical practice guidelines for the treatment of depression note that ECT is a highly efficacious treatment with a strong evidence base, particularly for patients with severe or psychotic depression, catatonia, high risk of suicide, or who have not responded to adequate trials of medication or psychotherapy [808]. However, only one study to date has assessed the efficacy of ECT in treating co-occurring depression and AOD use disorders [1123]. This study, a retrospective chart review comparing depressed patients with and without co-occurring AOD use disorders, found that patients with co-occurring alcohol use disorders experienced similar improvements in their depressive symptoms following ECT as those with mood disorders alone [1123]; however, patients with both co-occurring alcohol and drug use disorders experienced smaller improvements post-ECT than those with mood disorders alone [1123].

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