ECT in the treatment of depressed elderly: lessons from a terminated clinical trial

Stek, Max L.; Wurff, F. B. van der; Uitdehaag, Bernard M. J.; Beekman, Aartjan T.F.; Hoogendijk, Witte J.G.

doi:10.1002/gps.1800

Cited by 14 publications

(9 citation statements)

References 4 publications

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“…Previous studies have reported major difficulties in recruiting frail elderly depressed patients displaying psychomotor retardation and indecisiveness to take part in neuropsychological testing prior to ECT (Gardner and O'Conn, 2008;O'Connor et al, 2010;Stek et al, 2007). Thus, the small sample sizes of these studies did not make it possible to assess the predictive value of test results.…”

Section: Discussionmentioning

confidence: 89%

Baseline cognitive function does not predict the treatment outcome of electroconvulsive therapy (ECT) in late-life depression

Bjølseth

Engedal

Benth

et al. 2015

Journal of Affective Disorders

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Section: Discussionmentioning

confidence: 89%

Baseline cognitive function does not predict the treatment outcome of electroconvulsive therapy (ECT) in late-life depression

Bjølseth

Engedal

Benth

et al. 2015

Journal of Affective Disorders

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“…Systematically collected baseline brain imaging data might have added interesting information to our study, both because of the inclusion of patients with known mild cerebrovascular changes and the generally expected findings of clinically relevant "silent" brain changes on MRI in elderly depressed patients (Vermeer, Longstreth, & Koudstaal, 2007). However, the severe difficulties that are reported regarding the recruitment of elderly patients into studies of cognitive side effects of ECT (O'Connor et al, 2010;Stek, van der Wurff, Uitdehaag, Beekman, & Hoogendijk, 2007) might increase if patients have to consent to MRI assessment in addition to treatment with ECT and cognitive testing for participation in the study.…”

Section: Discussionmentioning

confidence: 95%

The Role of Baseline Cognitive Function in the Neurocognitive Effects of Electroconvulsive Therapy in Depressed Elderly Patients

Dybedal

Tanum

Bjølseth

2015

The Clinical Neuropsychologist

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“…It is difficult to conduct a randomized controlled trial (RCT) of ECT as illustrated by a relatively recent study that was terminated because of participants’ refusal to be randomized to ECT (67). However, this study offered randomization after failing one antidepressant.…”

Section: Discussionmentioning

confidence: 99%

Brain Stimulation in the Treatment of Late-Life Severe Mental Illness Other than Unipolar Nonpsychotic Depression

Liu¹,

Rajji²,

Blumberger³

et al. 2014

The American Journal of Geriatric Psychiatry

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Late-life mental illness is a growing concern. Current medications have limited efficacy and are associated with safety concerns. A variety of brain stimulation approaches offer alternative treatments. We performed a systematic literature search on the efficacy and safety of brain stimulation in late-life mental illnesses, excluding unipolar non-psychotic depression. Studies on deep brain stimulation (DBS), electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), and vagal nerve stimulation (VNS) that enrolled exclusively older adults (age 65 or older) or analyzed older adults as a separate group were included. The search identified 1,181 publications, of which 43 met the above inclusion criteria: 24 were related to the treatment of non-unipolar depression (ECT: 21; rTMS: 2; ECT and rTMS: 1), 14 to dementia (ECT: 7; VNS: 2; rTMS: 4; DBS: 1) – three ECT studies included under both depression and dementia – and 7 to schizophrenia (ECT: 7). These studies reported a high degree of variability in efficacy and safety with promising results in general, particularly in the treatment of dementia and schizophrenia. Most publications were limited by small sample sizes, lack of control conditions, and lack of randomization. Large studies with a randomized controlled design or other designs such as crossover or off-on-off-on are needed. In contrast to the empiric and nonspecific use of ECT, future studies using modalities other than ECT could focus on novel biologically-based interventions that can target specific circuitry. These interventions could also be combined with other non-brain stimulation treatments for possible synergistic effects.

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ECT in the treatment of depressed elderly: lessons from a terminated clinical trial

Cited by 14 publications

References 4 publications

Baseline cognitive function does not predict the treatment outcome of electroconvulsive therapy (ECT) in late-life depression

Baseline cognitive function does not predict the treatment outcome of electroconvulsive therapy (ECT) in late-life depression

The Role of Baseline Cognitive Function in the Neurocognitive Effects of Electroconvulsive Therapy in Depressed Elderly Patients

Brain Stimulation in the Treatment of Late-Life Severe Mental Illness Other than Unipolar Nonpsychotic Depression

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