Journal of Advanced in Medicinal, Pharmaceutical and Biomedical Research (JAMPBR)

Cognitive Protection after ECT: A Randomized Trial of Donepezil and Liothyronine in Mood Disorder Patients

Articles in Press

Document Type : Original Article

Authors

Angela Hamidia 1
Hamid Sadegh 2
Mahfam Mojazi-Amiri 3

1 Department of Psychiatrics, Babol University of Medical Sciences, Babol, Mazandaran, Iran

2 Department of Psychiatrics, Babol University of Medical Sciences, Babol, Mazandaran, Iran.

3 Department of Psychiatry, Babol University of Medical Sciences, Babol, Mazandaran, Iran.

10.22034/jampbr.2026.601770.1129
Abstract
Background: Electroconvulsive therapy (ECT) is one of the most effective interventions available for severe or treatment-resistant mood disorders such as major depressive disorder (MDD) and bipolar depression, yet it is commonly accompanied by cognitive adverse effects that can hinder recovery and reduce quality of life. This trial was designed to assess whether donepezil, a cholinesterase inhibitor, and liothyronine, a synthetic thyroid hormone, could lessen the cognitive impairment that often follows ECT.

Methods: Sixty inpatients with mood disorders scheduled for ECT were allocated at random to one of three arms — liothyronine 25 mcg/day, donepezil 5 mg/day, or donepezil 10 mg/day. Cognition was evaluated with the Addenbrooke’s Cognitive Examination, Third Edition (ACE-III), before treatment began, 24 hours after the last ECT session, and again at one and two months afterward.

Results: Scores on the ACE-III rose over time in every arm across the attention, memory, fluency, and language domains, and none of the three groups differed significantly from one another at any assessment point — indicating that donepezil and liothyronine conferred a similar degree of cognitive protection.

Conclusion: Both donepezil and liothyronine appear effective in reducing ECT-related cognitive impairment. Either agent may reasonably be considered as an adjunctive treatment to help preserve cognitive function in patients undergoing ECT.

Keywords

donepezil
liothyronine
thyroid hormone
electroconvulsive therapy
cognitive impairment
mood disorders
Subjects
Journal of Advanced in Medicinal, Pharmaceutical and Biomedical Research (JAMPBR)

Articles in Press, Accepted Manuscript
Available Online from 09 September 2026

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