- Design
- Double-blind randomised pilot trial
- Population
- 55 adults with bipolar depression; 45 with an adequate course
- Primary outcome
- HRSD-24 remission and autobiographical memory decline
- Effect
- Remission 30% ECT vs 20% MST; memory decline 22.2% vs 7.1%
CORRECT-BD, a double-blind randomised pilot published in May 2026, compared magnetic seizure therapy with right unilateral ultrabrief-pulse ECT for bipolar depression. Treatment continued to remission, dropout or 21 sessions. Of 55 randomised, 45 had an adequate course.
Remission occurred in 6 of 20 (30%) after ECT and 5 of 25 (20%) after magnetic seizure therapy. A clinically important fall in autobiographical memory, a decline of 25% or more, affected 6 of 27 (22.2%) in the ECT group and 2 of 28 (7.1%) after magnetic seizure therapy. Secondary clinical outcomes were similar.
This is a pilot, not an equivalence trial, and the remission numbers lean towards ECT. What it does is keep magnetic seizure therapy in play as a lower-cognitive-burden option worth a definitive trial. It is available in very few centres, and ECT remains the established treatment for severe or treatment-resistant bipolar depression.
- ECT remains the evidence-based option for severe bipolar depression; this pilot does not change that.
- Magnetic seizure therapy was associated with less autobiographical memory loss in a small trial.
- Remission was numerically lower with magnetic seizure therapy, 20% against 30%, and the trial was not powered to compare them.
- When discussing ECT, describe right unilateral ultrabrief-pulse technique as a way to limit memory effects.
Why it matters
Fear of memory loss keeps many patients from ECT, and a gentler alternative would widen access to convulsive therapy.
Don't overread it
With 45 treated participants, the trial cannot show that the two treatments are equally effective.
The statistics, in plain English
Small numbers mean a 10-point gap in remission could be chance in either direction. The memory finding is more striking but rests on eight events in total.
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