Background

Early studies reported a prolactin surge during electroconvulsive therapy (ECT). The aim of this study is to review and meta-analyze data on ECT-related prolactin changes.

Method

A systematic review and meta-analysis was conducted for trials investigating prolactin changes in ECT-treated patients using standard mean differences (SMD, 95% confidence intervals). Subgroup analyses included comparisons of ECT-related prolactin changes in women vs. men, patients receiving different anesthetics, bilateral vs. unilateral and high-vs. low-dose ECT.

Results

In six trials including 109 ECT-treated patients and 74 controls, prolactin changes were larger in ECT-treated patients than in controls (SMD = 0.89, 95%CI = 0.55, 1.23, p < 0.001 and 1.03, 95%CI = 0.31, 1.75, p = 0.005 for the fixed and random-effect model respectively), despite heterogeneity in the samples (I² = 72%, τ² = 0.62). Effects were led by differences in patients premedicated with methohexital (SMD = 1.14, 95%CI = 0.7, 1.57, p < 0.001 for both fixed and random-effect model). A meta-regression reported significant age effects (coefficient estimate 2.32, 95%CI = −0.73, 3.91, p < 0.01). Additionally, prolactin changes were larger in ECT-treated women than men (SMD = 0.88, 95%CI = 0.58, 1.18, p < 0.001 and 0.99, 95%CI = 0.22, 1.75, p = 0.012 for the fixed and random effect model). Bilateral ECT-treated patients had larger increase than unilateral ECT-treated patients (SMD = −0.81, 95%CI = −1.35, −0.27, p = 0.003 and −0.86, 95%CI = −1.46, −0.25, p = 0.006 for the fixed and random-effect model). Comparisons between high- and low-dose ECT-treated patients could not be conducted. The quality of the studies was overall poor, with four exceptions.

Discussion

Patients receiving ECT had larger prolactin increases than controls. Increases were larger in methohexital-premedicated patients, women vs. men and patients with bilateral vs. unilateral ECT.

中文翻译：

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电惊厥治疗过程中催乳素的变化：系统评价和荟萃分析。

背景

早期研究报道了电惊厥疗法（ECT）期间催乳素激增。这项研究的目的是审查和荟萃分析与ECT相关的催乳激素变化的数据。

方法

对于使用标准均数差（SMD，95％置信区间）调查ECT治疗患者的催乳激素变化的试验，进行了系统的综述和荟萃分析。亚组分析包括比较女性与男性，接受不同麻醉药的患者，双侧与单侧以及高视野患者的ECT相关催乳素变化。低剂量ECT。

结果

在六项试验中，包括109名接受ECT治疗的患者和74名对照组，ECT治疗组患者的催乳素变化大于对照组（SMD = 0.89，95％CI = 0.55，1.23，p <0.001和1.03，95％CI = 0.31， 1.75，p = 0.005，用于分别固定和随机效应模型），尽管样品（在异质我²  = 72％，τ ² = 0.62）。预先用甲氨蝶呤治疗的患者的差异可导致疗效（固定效应和随机效应模型的SMD = 1.14、95％CI = 0.7、1.57，p <0.001）。荟萃回归显示了显着的年龄影响（系数估计值2.32，95％CI = -0.73，3.91，p <0.01）。此外，接受ECT治疗的女性的催乳素变化大于男性（对于固定和随机效应模型，SMD = 0.88，95％CI = 0.58，1.18，p <0.001和0.99，95％CI = 0.22，1.75，p = 0.012 ）。双边ECT治疗的患者比单侧ECT治疗的患者有更大的增加（SMD = -0.81，95％CI = -1.35，-0.27，p = 0.003和-0.86，95％CI = -1.46，-0.25，p = 0.006固定和随机效应模型）。无法对ECT治疗的高剂量和低剂量患者进行比较。研究质量总体较差，但有四个例外。

讨论区

接受ECT治疗的患者泌乳素增加量大于对照组。在以甲氧他沙定为药物治疗的患者，女性与男性以及双侧与单侧ECT患者中，增加幅度更大。