Abstract
Objective: Inflammatory and immune mechanisms are reported to play important roles in the pathophysiology of psychiatric disorders. Electroconvulsive therapy (ECT) is regarded as an effective treatment of not only depression, but also schizophrenia and mania, especially when there is no response to pharmacological interventions. Despite the common use of ECT, its mechanism of action is mostly unknown. Few studies examined the effect of ECT on inflammatory and immune functions. The neutrophil–lymphocyte ratio (NLR) is a simple and easily accessible indicator of the systemic inflammatory response. Our aim was to investigate whether a series of ECT sessions would change NLR in patients with major depression, bipolar disorder, or schizophrenia.
Method: In this retrospective study, we analyzed 61 patients (unipolar depression, n=35; acute mania n=13; and schizophrenia, n=13). Complete blood count measurements were recorded before and after repeated ECT treatment.
Results: We found no difference in NLR between before (2.27±2.54) and after (2.49±1.65) repetaed ECT treatments (p>0.05). Furthermore, a series of ECT did not change NLR in seperate diagnostic groups.
Conclusions: To our knowledge, this is the first study to evaluate the impact of ECT on NLR. Our findings suggest that NLR levels are not altered after repeated ECT treatments.

Key words: electroconvulsive therapy, neutrophil/lymphocyte ratio, inflammation, immunology