Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: BDNF, antidepressants and ECT

Forum: Neurology Forum
Topic: AMYOTROPHIC LATERAL SCLEROSIS - ALS

I read about a study done at the Yale University School of Medicine (by Duman et al in 1995) showing that (in animal studies) chronic electroconvulsive treatment (ECT) and anti-depressant therapy could actually promote neuronal survival and protect neurons from the damaging effects of stress. It further stated that this type of therapy could increase and prolong the life of BDNF (brain derived neurotrophic factor) within the brain.
Recent animal research has shown that BDNF drugs can slow down the rate of ALS disease progression and currently there are human trials being conducted testing the efficacy of chemically engineered BDNF and other drugs which increase BDNF levels within the body .
Couldn't ECT and antidepressant therapy possibly work to slow down the rate of progression of degenerative neurological diseases like ALS or Parkinsons? Your input would be greatly appreciated.
Dear SIerra,

thank you for the question. It is an interesting one. I am somewhat familiar with the study you quoted. I think the author, like in many experimental animal studies, while understand the limitations of their study, almost always make a statement that can lead to further study in the conclusion section.
Whether it is true, practical, or even feasible, is a different story.

We at Cleveland Clinic are participating in the BDNF trial for our ALS patients. I can say that many of our patients also take antidepressant medications along with the study drug but I have not come across one who had a serious enough depression to warrant ECT or who have had ECT treatment for depression previously. This raises the following issue: if antidepressant indeed can prolong motor neuron survival, and increase the BDNF level, then it is a confounding factor, and the BDNF data need to be reexamined. Of those of respond favorably, how many were on antidepressant ? I don't know the answer to these questions. So for now, we don't take them off their antidepressant while on the study, or while on the study drug sometimes we add an antidepressant. So until the relationship is better defined, I think we will continue this approach.
Let's hope we find a cure for ALS soon. Thank you for your support.

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