A gentler alternative to ECT for bipolar depression?
If someone you love has bipolar disorder and ECT has been suggested, the first worry is usually memory. A new trial in the American Journal of Psychiatry has some early, hopeful news on that.
The CORRECT-BD trial, run at four Canadian academic health centers, compared ultrabrief ECT with magnetic seizure therapy (MST) in 55 adults with bipolar depression. Like ECT, MST brings on a brief, controlled seizure under anesthesia. It uses magnetic pulses instead of electrical current, which lets it target the brain more precisely.
Depression and suicidal thinking improved by similar amounts in both groups. The difference was in memory. 22.2% of people who received ECT had a meaningful drop in memory for their own life events, compared with 7.1% with MST. People also regained orientation faster after MST, in about 7 minutes versus 19. “By stimulating the brain more precisely, MST appears to offer comparable levels of therapeutic benefit, while greatly reducing side effects on memory and cognition,” said Dr. Fidel Vila-Rodriguez, who led the Vancouver site.
This was a small pilot study, and MST isn’t yet a standard treatment. It’s mostly offered through research programs. ECT is still one of the most effective treatments for severe depression. If it’s recommended for your loved one, you can ask:
- Which type of ECT will be used? Right unilateral ultrabrief ECT tends to cause fewer memory effects.
- How will memory be checked before and during treatment?
- Is there an MST study nearby? You can search ClinicalTrials.gov.
A monthly olanzapine shot without the three-hour wait
If someone you love has schizophrenia and does well on olanzapine but struggles to take a pill every day, there’s a new option. On Oct. 9, the FDA approved Weltruza, a once-monthly olanzapine injection given under the skin rather than into the muscle.
Here’s why that matters for families. Olanzapine has been available as a long-acting injection for years. But because of a rare reaction that can cause heavy sedation or confusion after a shot, the existing version requires a certified facility and three hours of observation after every injection. For many families, that’s a half day of work missed every month. Weltruza doesn’t require post-injection monitoring. In the SOLARIS trial, no cases of that reaction were seen across nearly 4,000 injections, though the label still carries the warning.
A few things to know:
- It’s given once a month, with no loading doses or extra pills to start.
- Side effects mirror oral olanzapine, including weight gain and metabolic changes, so ongoing monitoring of weight, blood sugar and cholesterol still matters.
- Teva expects it to be available in the U.S. “in the coming weeks.”
If your loved one is stable on olanzapine but missing doses, this is worth raising at the next appointment. Questions to ask: Is this a fit? Where would injections be given? Will insurance cover it?
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