Findings seen for both suicide and overall mortality, with even stronger effects seen in more recent studies
By Lori Solomon HealthDay Reporter
WEDNESDAY, June 18, 2025 (HealthDay News) — Electroconvulsive therapy (ECT) shows a significant protective effect against suicide and overall mortality in people with depression, according to a review published online June 12 in Neuroscience Applied.
Jolein Odermatt, from the University of Basel in Switzerland, and colleagues conducted a systematic literature review to identify studies investigating the impact of various neurostimulation techniques, including ECT, repetitive transcranial magnetic stimulation (rTMS), and vagus nerve stimulation (VNS), on reducing suicidality (suicidal ideation and completed suicides), as well as on overall mortality among individuals diagnosed with depression.
The researchers identified 26 eligible studies, including 11 studies on ECT (17,890 participants treated with ECT and 25,367 controls), five studies on rTMS, and three studies on VNS. Overall, there were 208 suicide deaths (1.70 percent) in the ECT group and 988 suicide deaths (5.02 percent) in the control group, as well as 511 deaths from all causes (3.13 percent) in the ECT group and 1,325 deaths (6.64 percent) in the control group. Treatment with ECT showed a significant decrease in the odds of suicide (odds ratio [OR], 0.66) and for death from all causes (OR, 0.70). ECT showed a moderate effect size with a standardized mean difference (SMD) for suicidal ideation before and after treatment of −0.58. There was no significant effect of rTMS on suicidal ideation, with an SMD of −0.41. For patients treated with VNS, there was a significant reduction seen in the odds of death from all causes (OR, 0.40).
“We observed that newer studies tended to report greater benefits from ECT than older ones. These more recent studies are often larger and methodologically stronger, reflecting how ECT treatment has evolved over time,” lead author Timur Liwinski, M.D., also from University of Basel, said in a statement. “Since our analysis spans many decades, it’s likely that today’s ECT offers even stronger protection against suicide than the 34 percent reduction we identified overall.”
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