Assessing the Efficacy of Cognitive Enhancers in Electroconvulsive Therapy: A Randomized Controlled Trial of Rivastigmine and Memantine
Bibliographic record
Abstract
OBJECTIVE: Electroconvulsive therapy (ECT) is an effective treatment for severe psychiatric disorders but is frequently associated with cognitive side effects. This study aimed to evaluate the effects of rivastigmine and memantine on cognitive function following ECT. METHODS: In this multicenter, randomized, double-blind, placebo-controlled trial (registration number: IRCT20190119042417N2), 45 patients receiving ECT were allocated equally to rivastigmine, memantine, or placebo groups. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) at baseline, week 2, and week 6. Individual slopes of MoCA change over time were computed using simple linear regression, and group-level comparisons were conducted using t tests and adjusted linear models. RESULTS: Patients receiving rivastigmine showed a significantly greater improvement in weekly MoCA scores compared with placebo (mean slope=+0.42 vs. -0.11 points/week; P =0.006; Cohen d=1.40). Memantine was associated with a positive slope (+0.24 points/week), but the effect was not statistically significant after adjusting for baseline cognitive status and covariates. CONCLUSIONS: Rivastigmine may enhance cognitive recovery following ECT. Memantine showed a positive but nonsignificant effect. These findings support the potential utility of cholinergic modulation in mitigating ECT-related cognitive deficits. Future research should explore combination therapies and utilize more sensitive, domain-specific cognitive assessments.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.015 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".