Coadministration of melatonin and fluoxetine does not improve the 3-month outcome following ECT

L. Grunhaus, S. Hirschman, O. T. Dolberg, S. Schreiber, P. N. Dannon

Research output: Contribution to journalArticlepeer-review


At least 50% of patients with manic depressive disorder (MDD) treated successfully with electroconvulsive therapy (ECT) will experience a relapse within the first year of follow-up. Sleep disturbances are very common in MDD and may constitute forerunners of relapse. In this study we tested the hypothesis that melatonin, a sleep-promoting hormone, would decrease the 3-month relapse rate after successful ECT. We included in the study patients with MDD successfully treated with ECT (post-ECT Hamilton Rating Scale for Depression [HRSD] ≤ 10). Patients were blindly randomized to two groups, one receiving fluoxetine + placebo and one receiving fluoxetine + melatonin. Assessments (HRSD, Brief Psychiatric Rating Scale, Global Assessment of Function Scale, Global Depression Scale, Pittsburgh Sleep Quality Index, Mini-Mental State Exam, and pill count) were performed for 12 weeks after ECT. Ten of the 35 patients (28.5%) relapsed during the follow-up period. Relapse rates were similar in both groups of patients. Sleep reports were not improved by melatonin. Patients who achieved a higher functional state post-ECT relapsed less often. We conclude that the addition of melatonin to on-going fluoxetine treatment did not have a beneficial effect either on the 3-month outcome post-ECT or on the sleep reports of these patients.

Original languageEnglish
Pages (from-to)124-128
Number of pages5
JournalJournal of ECT
Issue number2
StatePublished - 2001
Externally publishedYes


  • Electroconvulsive therapy
  • Major depression
  • Manic depressive disorder
  • Melatonin
  • Outcome


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