The consortium of Researchers for ECT (CORE) - past, present and future

Abstract

Abstract The Consortium of Researchers for ECT (CORE) was established in 1996 with the goal to conduct multicenter clinical trials in Electroconvulsive Therapy (ECT). The group comprised of four clinical sites: Medical University of South Carolina (MUSC) in Charleston, SC, Mayo Clinic, Rochester MN, University of Texas SW, Dallas TX, and Hillside Hospital, Glen Oaks NY, NY. The database coordinating center was based at MUSC. The CORE group conducted 3 multicenter clinical trials, all funded by the National Institute of Mental health (NIMH). The first study by the group compared the clinical outcomes of 201 patients who were randomly assigned to receive continuation ECT or continuation pharmacotherapy for 6 months after a successful course of bitemporal ECT for major depression. This is the first randomized controlled trial to establish the clinical effectiveness of continuation ECT. The second study by the CORE group, with the addition of the New Jersey Medical School in Newark, NJ and the subtraction of the clinical site of MUSC, compared the effectiveness and tolerability of the 3 most used electrode placements, i.e. bitemporal, bifrontal and right unilateral (RUL) for the treatment of unipolar depression. The study found only numerical but no statistically significant differences in the efficacy and tolerability of the 3 placements with bitemporal slightly more effective than bifrontal and frontal slightly more effective than RUL. The third study by the group, Preventing Relapse in Depressed Elderly (PRIDE) compared the efficacy and tolerability of continuation ECT plus venlafaxine to venlafaxine alone in preventing relapse after acute ECT in geriatric patients. The combination of venlafaxine and continuation ECT was superior to venlafaxine alone. We’ll discuss in detail the primary results of the above studies, as well as additional analyses that have contributed to the shaping of the current clinical practice of ECT. Keywords: Electroconvulsive, Multicenter, Depression, Research Collaboration