The Use of ECT in the Elderly-Looking Beyond Depression
- PMID: 35829850
- DOI: 10.1007/s11920-022-01353-0
The Use of ECT in the Elderly-Looking Beyond Depression
Abstract
Purpose of review: We reviewed recent evidence on the use of electroconvulsive therapy (ECT) in the geriatric population. This review looked at the literature on depression, for which there is a breadth of data, as well as other conditions that have historically not been as well studied, as well as attempting to provide practical recommendations for ECT practitioners. This review also examined the impact of the COVID-19 pandemic on ECT in the elderly.
Recent findings: ECT shows robust efficacy across many psychiatric diseases, from depression and bipolar disorder to psychosis and catatonia. It has also shown positive results at improving behavioral symptoms of dementia, as well as improving motor symptoms seen in Parkinson's disease. It is routinely found to be a safe treatment as well, generally with only minimal transient side effects. ECT should not be considered a "last-resort" treatment for geriatric patients suffering from psychiatric disorders. It has historical and recent literature supporting its use in many psychiatric disorders and has been shown to be safe with minimal side effects when appropriate considerations are taken for the elderly population.
Keywords: Dementia; Depression; ECT; Elderly; Electroconvulsive therapy; Geriatric.
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
-
- Berrios GE. The scientific origins of electroconvulsive therapy: a conceptual history. Hist Psychiatry. 1997;8(29):105–19. https://doi.org/10.1177/0957154x9700802908 . - DOI - PubMed
-
- Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis. The Lancet. 2003;361(9360):799–808. https://doi.org/10.1016/s0140-6736(03)12705-5 .
-
- •• Kellner CH, Husain MM, Knapp RG, McCall WV, Petrides G, Rudorfer MV, et al. Right unilateral ultrabrief pulse ECT in geriatric depression: phase 1 of the PRIDE study. Am J Psychiat. 2016;173(11):1101–9. https://doi.org/10.1176/appi.ajp.2016.15081101 . Multisite study showing efficacy for RUL-UB ECT plus Venlafaxine for depression in the elderly.
-
- •• Kellner CH, Husain MM, Knapp RG, McCall WV, Petrides G, Rudorfer MV, et al. A novel strategy for continuation ECT in geriatric depression: phase 2 of the PRIDE study. Am J Psychiat. 2016;173(11):1110–8. https://doi.org/10.1176/appi.ajp.2016.16010118 . Multisite study showing that additional ECT after attaining remission showed benefit in sustaining improved mood over medication alone.
-
- • Dominiak M, Goetz Z, Antosik-Wojcinska AZ, Swiecicki L. Right unilateral versus bilateral formula-based electroconvulsive therapy in the treatment of major depression in elderly patients: a randomised, open label, pilot controlled trial. Psychogeriatrics. 2021;21(2):175–84. https://doi.org/10.1111/psyg.12652 . Randomised controlled trial showing comparable efficacy in RUL and BL treatments, with improved tolerability in the RUL arm.
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