{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T06:51:21Z","timestamp":1787986281944,"version":"build-2784847793"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Psychiatry"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although antidepressant monotherapy is recommended for patients with major depressive disorder (MDD), they often do not respond to it, necessitating alternatives such as electroconvulsive therapy (ECT). However, maintenance pharmacotherapy after ECT has remained unestablished. This study, conducted at 240 facilities throughout Japan, aimed to explore maintenance pharmacotherapy after ECT for 3,749 inpatients with MDD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The patients were divided into two groups, one that underwent ECT (ECT group,\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009521) and another that did not (non-ECT group,\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20093,273), for the comparison of clinical characteristics and prescription details at discharge. The primary outcome of this study was the prescription rate of antidepressant monotherapy at discharge, while the secondary outcomes included prescription rates of specific combination regimens, such as antidepressant plus lithium.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified 198 prescription patterns involving antidepressants in the ECT group. Analysis by drug category revealed distinctive patterns: there was no statistically significant difference in prescription rates for antidepressant monotherapy between the ECT and non-ECT groups (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009118, 22.6% vs.\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009932, 28.4%). In contrast, the prescription rate for the combination of antidepressant and antipsychotic medications was significantly higher in the ECT group (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009188, 36.0% vs.\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009941, 28.7%). The combination of antidepressant and mood stabilizer was also more frequent in the ECT group (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200935, 6.7% vs.\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009130, 3.9%), although this difference did not reach statistical significance after Bonferroni correction. At the drug level, additional distinctive patterns emerged: among antidepressant monotherapies, nortriptyline use was significantly more common in the ECT group (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20099, 1.7% vs.\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200911, 0.3%). For mood stabilizers, restricting the analysis to lithium revealed a markedly higher rate in the ECT group (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200930, 5.7% vs.\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200935, 1.0%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings highlight the complexity of treatment decisions managing of MDD after ECT and emphasize the need for structured prospective research on the effectiveness of specific maintenance pharmacotherapies after ECT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12888-025-07445-4","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T12:20:36Z","timestamp":1760012436000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Maintenance pharmacotherapy after electroconvulsive therapy in inpatients with major depressive disorder: 198 prescriptions in a real-world clinical setting"],"prefix":"10.1186","volume":"25","author":[{"given":"Shun","family":"Igarashi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Tsuboi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Hasegawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichiro","family":"Ochi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazutaka","family":"Ohi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Fukumoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun-ichi","family":"Iga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Muraoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Iida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumitoshi","family":"Kodaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shusuke","family":"Numata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayo","family":"Ichihashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroko","family":"Kashiwagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshinori","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotaka","family":"Yamagata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Takeshima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Nagasawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junya","family":"Matsumoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisashi","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hikaru","family":"Hori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Inada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norio","family":"Yasui-Furukori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryota","family":"Hashimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,9]]},"reference":[{"key":"7445_CR1","doi-asserted-by":"crossref","unstructured":"Rush AJ, Trivedi. 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The study was conducted in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"We have no conflict of interest with any commercial or other association connected with the submitted article.Relevant financial activities outside the submitted work in the past 36\u2009months are as follows: Shun Igarashi received personal fees from Sumitomo Pharma. Takashi Tsuboi received a grant from Japan Society for the Promotion of Science and honorarium from Takeda Pharmaceutical, Otsuka Pharmaceutical, Meiji Seika Pharma, Shionogi Pharma, Yoshitomiyakuhin, Sumitomo Pharma, Kyowa Pharmaceutical, MSD, Nippon Boehringer lngelheim, Mylan EPD, Mitsubishi Tanabe Pharma, Viatris, Mochida Pharmaceutical, Janssen Pharmaceutical, TEIJIN PHARMA, and Lundbeck Japan. Shinichiro Ochi received rewards for lectures from Sumitomo Pharma Co. Ltd., Meiji Seika Pharma Co. Ltd., Otsuka Pharmaceutical Co. Ltd., and Eisai Co., Ltd. Kazutaka Ohi received personal fees from Lundbeck Japan, Takeda Pharmaceutical, Meiji Seika Pharma, MSD, Otsuka, Sumitomo Pharma, Viatris, Kyowa Pharmaceutical Industry, Yoshitomiyakuhin, Mitsubishi Tanabe Pharma, and Mochida. Kentaro Fukumoto received personal fees from Janssen, Lundbeck Japan, Meiji Seika Pharma, Mitsubishi Tanabe Pharma, MSD, Otsuka Pharma, Sumitomo Pharma, Takeda pharma. Jun-ichi Iga has received speaker\u2019s honoraria from Eisai, Sumitomo Pharma, Takeda Pharmaceutical, Meiji Seika Pharma, VIATRIS, Sanofi, Kyowa Pharmaceutical, MSD, Otsuka Pharmaceutical, Kowa Company, Yoshitomi, Janssen Pharmaceutical, Shionogi, Nippon Boehringer Ingelheim, Lundbeck Japan, MOCHIDA PHARMACEUTICAL, Nobelpharma, DAIICHI SANKYO, YONYAKU. Hiroyuki Muraoka received personal fees from Eisai, Janssen, Lundbeck Japan, Takeda Pharmaceutical, Meiji Seika Pharma, MSD, Otsuka, Sumitomo Pharma, Viatris, Kyowa Pharmaceutical Industry. Hitoshi Iida has received speaker\u2019s honoraria from Eisai, Sumitomo Pharma, Takeda Pharmaceutical, Meiji Seika Pharma, VIATRIS, EA Pharma, Kyowa Pharmaceutical, MSD, Otsuka Pharmaceutical, Kowa Company, Yoshitomi, Janssen Pharmaceutical, Eli Lilly, Shionogi. Fumitoshi Kodaka received lecture fees from Jansen Pharmacuticals, Lundbeck K.K, MEIJI Seika Pharma, Otsuka and grant from Mochida Pharmaceuticals. Shusuke Numata received lectures fees from Sumitomo Pharma Co., Ltd., MSD K.K., Lundbeck Japan K.K., Meiji Seika Pharma Co., Ltd., TEIJIN PHARMA LIMITED., Mitsubishi Tanabe Pharma Corporation., DAIICHI SANKYO COMPANY, LIMITED., Eisai Co., Ltd., Otsuka Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited., Janssen Pharmaceutical K.K., Mochida Pharmaceutical Co. Ltd., Kowa Co., Ltd., Yoshitomiyakuhin Corporation and research grants from Otsuka Pharmaceutical Co. Ltd., Sumitomo Pharma Co., Ltd. Kayo Ichihashi received honoraria for educational events from Janssen Pharmaceutical K.K., for lectures from MSD Co. Ltd., Nobelpharma Co. Ltd., and Takeda pharmaceutical Co. Ltd. Hiroko Kashiwagi received personal fees from Sumitomo Pharma. Toshinori Nakamura received honoraria for lectures from Otsuka Pharmaceutical, Eisai, Sumitomo Pharma, MSD, Janssen Pharmaceutical K, Lundbeck Japan, and Takeda Pharmaceutical Co., Ltd. Hirotaka Yamagata received honoraria from Eisai, Sumitomo Dainippon Pharma, Mochida Pharmaceutical, Viatris, Otsuka Pharmaceutical, and Meiji Seika Pharma. Masahiro Takeshima received speaker\u2019s honoraria from EISAI Co., Ltd. and MSD Inc., Takeda Pharmaceutical Co., Ltd, Otsuka Pharmaceutical, Janssen Pharmaceutical K.K., Sumitomo Pharma Co., Ltd, and Meiji Seika Pharma. Co., Ltd, and consultation fee for AbbVie GK, outside the submitted work. Tatsuya Nagasawa received personal fees from Takeda Pharmaceutical, Daiichi-Sankyo, Eisai, Janssen Pharmaceutical, Lundbeck Japan, Mitsubishi Tanabe Pharma, Mochida, MSD, Otsuka, Sumitomo Pharma, Kyowa Pharmaceutical and Viatris. Junya Matsumoto received lecture fees from Sumitomo Pharma. Hisashi Yamada has received speaker\u2019s honoraria from Eisai, Sumitomo Pharma, Takeda Pharmaceutical, Meiji Seika Pharma, VIATRIS, Kyowa Pharmaceutical, MSD, Otsuka Pharmaceutical, Lundbeck Japan, MOCHIDA PHARMACEUTICAL, Tanabe Mitsubishi Pharma, Towa Pharma, Nipro. Hikaru Hori received lecture fees from Sumitomo Pharma, Otsuka Pharmaceutical, Takeda Pharmaceutical Co., Ltd, Janssen Pharmaceutical K. Ken Inada received personal fees from Daiichi-Sankyo, Eisai, Eli Lilly, Janssen, Lundbeck Japan, Meiji Seika Pharma, Mitsubishi Tanabe Pharma, Mochida, MSD, Nipro, Novartis, Otsuka, Pfizer, Shionogi, Sumitomo Pharma, Yoshitomiyakuhin, Viatris, and research grant support from Mochida, Otsuka and Sumitomo pharma. Norio Yasui-Furukori received personal fees from Daiichi-Sankyo, Eisai, Eli Lilly, Janssen, Lundbeck Japan, Meiji Seika Pharma, Mitsubishi Tanabe Pharma, Mochida, MSD, Novartis, Otsuka, Sumitomo Pharma, Tsumura, Yoshitomiyakuhin, Viatris, and he received research grant support from Mochida, Otsuka and Sumitomo pharma. Ryota Hashimoto received honoraria for lectures from Otsuka Pharmaceutical Co., Ltd., Janssen Pharmaceutical K.K., Sumitomo Pharma Co., Ltd., and Meiji Seika Pharma Co., Ltd., and honoraria for scientific interview from Boehringer Ingelheim International GmbH. Koichiro Watanabe received grants from Eisai, Meiji Seika Pharma, Mitsubishi Tanabe Pharma, MSD, Otsuka Pharmaceutical, Sumitomo Dainippon Pharma, Takeda Pharmaceutical, speaker\u2019s honoraria from Astra Zeneca, Boehringer Ingelheim, Eisai, Janssen Pharmaceutical, Kyowa Pharmaceutical, Lundbeck Japan, Meiji Seika Pharma, Mitsubishi Tanabe Pharma, MSD, Otsuka Pharmaceutical, Shionogi, Sumitomo Dainippon Pharma, Takeda Pharmaceutical, Teijin Pharma, Viatris, and consulting fees from Boehringer Ingelheim, Daiichi Sankyo, Eisai, Janssen Pharmaceutical, Kyowa Pharmaceutical, Lundbeck Japan, Luye Pharma, Mitsubishi Tanabe Pharma, Otsuka Pharmaceutical, Sumitomo Dainippon Pharma, Takeda Pharmaceutical, and Viatris.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"957"}}