Cognitive Performance in Patients with Depression Treated with Electroconvulsive Therapy

Abstract Background: Electroconvulsive therapy (ECT) is a highly effective treatment for severe and treatment-resistant depression, yet concerns remain regarding its cognitive side effects. The study aimed to assess changes in cognitive performance in patients with depression undergoing ECT and to evaluate the trajectory of recovery after treatment. Materials and Methods: A total of 95 patients diagnosed with depression were assessed over a three-year period. Cognitive performance was measured at four time points: before treatment, prior to the fourth session, within three days after ECT completion, and for a subgroup of 31 patients also six weeks post-treatment. The Montreal Cognitive Assessment (MoCA) was used for initial screening, and the MATRICS Consensus Cognitive Battery (MCCB) was applied for detailed evaluation. Depressive symptoms were monitored using the Montgomery-Åsberg Depression Rating Scale (MADRS). Results: ECT led to significant improvement in depressive symptoms, with remission rates ranging from 60–80%. Initial cognitive decline was observed early in the treatment course, particularly in memory and new learning, but cognitive functioning improved as treatment progressed. At six weeks post-treatment, further recovery was evident, although cognitive scores remained below average baseline levels. Most short-term cognitive side effects resolved within weeks after ECT. Conclusion: ECT is a safe and effective intervention for severe depression, providing substantial symptomatic relief. While transient cognitive side effects occur, they are generally reversible, underscoring the importance of monitoring cognitive outcomes throughout treatment and follow-up.