Earlier ECT none response |
ECT within the last six months |
Rapid cycling BD (e.g.4 or more episodes per year) |
Use of medication or substances (such as pethidine, alcohol, drugs) incompatible with treatment (medication or ECT). Such medication must be stopped a least 5 half-lives before start of treatment. |
Current use of all other psychotropic medication during the study period with the exception of the following: The use of alimemazine (max dose 30 mg daily), chlorpromazine (max dose 25 mg × 2 daily) and chlorprothixene (max dose 20 mg × 2) is allowed. The use of mianserine (max dose 10 mg daily) is allowed.Medication related to the ECT procedure is allowed. |
For Medication in control group refer to Medication in control group - Treatment As Usual |
Inability to comply with study protocol |
Unstable serious medical conditions, including clinically relevant laboratory abnormalities |
Conditions that affect neuropsychological assessment such as Parkinson's Disease, Multiple sclerosis, stroke, alcohol and substance abuse or dependence (according to SCID or DSM-IV-TR) |
Fertile women without adequate contraception (Adequate contraception includes: abstinence, oral contraceptives, intrauterine devices, barrier method) |
Young Mania Rating Scale (YMRS) [43] of 20 or more |
Patient at high suicidal risk according to clinicians' judgement |