Bifrontal Electroconvulsive Therapy in the Elderly

Little, John; Atkins, Martin; Munday, Jo; Lyall, Gordon; Greene, Dennis; Chubb, Graeme; Orr, Michelle

doi:10.1097/00124509-200409000-00003

Cited by 13 publications

(2 citation statements)

References 9 publications

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“…The most consistent finding is that ECT is safe and effective in treating older adults with unipolar depression 15 . However, available evidence for this treatment in older adults with bipolar disorder is limited to small reports and case series 4,10,16,17 . The largest reported series of elderly patients with bipolar depression demonstrated successful treatment of 5 patients with bifrontal ECT 16 …”

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confidence: 99%

Electroconvulsive Therapy for Bipolar Depression in Older Adults

Morcos¹,

Maixner²,

Maixner³

2021

J ECT

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Objectives: Electroconvulsive therapy (ECT) is a well-established treatment for mood disorders in younger adults and has been consistently shown to be safe and effective in unipolar depression in older adults. However, data on this treatment in older adults with bipolar disorder are limited. In this retrospective study, we report outcomes from all cases of older adults with bipolar depression who received ECT from a large academic institution over a 7-year period. Methods:We retrospectively identified all patients 65 years and older with bipolar depression who were treated with ECT over a 7-year period. Patients receiving ECT for an episode of bipolar depression were included in the study based on chart review and availability of documented outcome measures. Primary outcomes were changes in Montreal Cognitive Assessment and Clinical Global Impressions scores. Results:We identified 34 patients meeting inclusion criteria. Collectively, patients had statistically significant improvement in Montreal Cognitive Assessment scores and reductions in Clinical Global Impressions severity scores after treatment. Pre-and posttreatment Montgomery-Asberg Depression Rating Scale scores were also available for a subset of 20 patients and demonstrated a similarly significant reduction in severity with treatment. There were no serious adverse effects of treatment, and no patients discontinued treatment. Conclusions:Electroconvulsive therapy was well tolerated and effective in treating bipolar depression in older adults. Importantly, these findings challenge commonly held worries about cognitive decline in older adults receiving ECT. It should be a regular consideration for management of this challenging illness in a population that may otherwise not respond to pharmacotherapy.

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confidence: 99%

Electroconvulsive Therapy for Bipolar Depression in Older Adults

Morcos¹,

Maixner²,

Maixner³

2021

J ECT

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“…One study examined real ECT versus simulated ECT [54], the second examined once weekly versus three times a week ECT [55], and the third looked at unilateral versus bilateral ECT [56]. Relapse and rehospitalization rates after ECT vary widely across studies from 7.1% at 2 years after treatment [57] to 38% after 1 year [58]. Unilateral ECT seemed to be more efficacious than bilateral ECT in the elderly.…”

Section: Response To Treatmentmentioning

confidence: 99%

Course and outcomes of depression in the elderly

Kohn

Epstein‐Lubow²

2006

Curr Psychiatry Rep

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Major depressive disorder is a potentially debilitating condition that often is unrecognized or undertreated in the elderly. Even when aggressively treated, the course of geriatric depression can be severe. There is growing evidence that suggests that late-life depression may carry a higher illness burden than depression with onset earlier in life, and that severity is linked to medical and psychiatric comorbidity. Data continue to accumulate in support of various treatment modalities, including medication, electroconvulsive therapy, and psychotherapy. Given the increased risk of adverse outcomes associated with geriatric depression, such as dementia and suicide, it is essential that future investigations continue to build on the evidence base supporting improved diagnosis and treatment of this complex disorder.

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Current awareness in geriatric psychiatry

2005

Int J Geriat Psychiatry

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of geriatric psychiatry. Each bibliography is divided into 9 sections: 1 Books, Reviews & Symposia; 2 General; 3 Assessment; 4 Epidemiology; 5 Therapy; 6 Care; 7 Dementia; 8 Depression; 9 Psychology. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted

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Bifrontal Electroconvulsive Therapy in the Elderly

Abstract: BF ECT was found to be clinically effective and associated with cognitive side effects in elderly patients who were experiencing a depressive episode of either unipolar or bipolar origin.

Cited by 13 publications

References 9 publications

Electroconvulsive Therapy for Bipolar Depression in Older Adults

Electroconvulsive Therapy for Bipolar Depression in Older Adults

Course and outcomes of depression in the elderly

Current awareness in geriatric psychiatry

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