The impact of melatonin on the alleviation of cognitive impairment during electroconvulsive therapy: A double-blind controlled trial

BackgroundThe purpose of this study was to assess the efficacy and safety of melatonin in the prevention of cognitive impairments during ECT treatment.MethodsForty patients diagnosed with a major depressive disorder, for which ECT was indicated as a treatment for their current episode, were randomly allocated to either the melatonin (3 mg/day) group or the placebo group. The patients received melatonin or the placebo for the whole period of the ECT treatment, starting the day before ECT and continuing until the sixth session of ECT. The Modified Mental State Examination (MMSE) and item 3 MMSE were used for the assessment of cognition. Objective measures of cognitive functioning were performed pre-ECT and post-ECT.ResultsIn both the MMSE score and item 3 MMSE, the melatonin group scored significantly higher at the end of the ECT sessions than the control group (P < 0.02, P = 0.001, respectively). None of the patients discontinued the melatonin or placebo due to side effects and there were no severe adverse drug reactions.ConclusionAlthough our data support the hypothesis that melatonin may reduce cognitive impairment following ECT, we believed that the findings provide an additional benchmark for further studies involving more patients.