Efficacy and safety of modified electroconvulsive therapy for the refractory depression in older patients

Abstract

Background: To explore the clinical efficacy and safety of modified electroconvulsive therapy (MECT) in the treatment of elderly patients with refractory depression. Methods : A total of 43 older patients (18 male and 25 female) with refractory depression were enrolled in our study from March 2014 to February 2015, with the average age of 65±4.8 years old. Modified electroconvulsive therapy (MECT) was performed in these patients after physical examinations and anesthesia procedures. Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were used to assess the efficacy of MECT, and Wechsler Memory Scale (WMS) and mini mental state examination (MMSE) were used to evaluate the memory ability and cognitive function. The preoperative, intraoperative and postoperative care were conducted in patients accompanied by physical diseases. Results: The rate of efficacy was calculated as 67.44% after 4 weeks of MECT treatment. Our results showed HAMA and HAMD scores after 2 weeks of MECT treatment were significantly lower than that before treatment (P<0.05), and the differences were more significant after 4 weeks of MECT treatment (P<0.01). Compared with before treatment, the scores of memory quotient and immediate memory of WMS decreased significantly after 1 week of treatment (P<0.05). However, these events were not be presented with the progress of treatment, except for after 2 weeks of treatment. Our results demonstrated that compared with before treatment, the scores of MMSE significantly increased significantly after 4 weeks of treatment (P<0.05). There were no serious adverse events in all patients, including cardiovascular and cerebrovascular events. Among them, 7 patients had transient blood pressure rise and slight headache, which were relieved spontaneously after resting. Conclusion: MECT is an effective, well tolerated and safe method for the treatment of older patients with refractory depression, which is temporary and reversible for cognitive impairment. MECT can be recommended for the treatment of these patients after conducting effective risk control of comorbid somatic diseases.

A review of attentional bias modification trainings for depression

“…In line with this point, a recent meta‐analysis revealed that only 41% of depressed patients receiving psychotherapy experienced significant alleviation of depressive symptoms 14 . In terms of the physical therapy, the transcranial magnetic stimulation (TMS) and modified electroconvulsive therapy (MECT) had been confirmed to have significant effects on depression 15,16 . The side effects of these physical therapies included but not limited to cognitive impairment (especially in memory), discomfort of head and face, facial convulsions, and so on, 7 which would limit their application.…”

Prevalence and Socio-Demographic Correlates of Poor Mental Health Among Older Adults in Agricultural Areas of China

“…Finally, Chinese traditions in agricultural areas may have a protective effect on mental health of older adults (54,55). For instance, older adults usually live with family members in China; thus, they could have better social support than their counterparts in big cities, which could reduce the risk of poor mental health (56)(57)(58). Further, Chinese elderly are commonly well-respected and cared for by their families and children as traditional Chinese culture emphasizes filial piety and reverence for seniors (8).…”

Trajectories of Efficacy and Cognitive Function During Electroconvulsive Therapy Course in Young Adults with Treatment-Resistant Depression

“… 20–22 ECT is associated with a reduced risk of suicide in the year after discharge. 23 While there is strong evidence supporting the efficacy of ECT in middle-aged and older adults, 24 , 25 little is known about its efficacy and cognitive side-effects in younger adults (aged 18–30) with TRD. Previous studies have suggested that ECT in young adults improves clinical outcomes during the acute treatment phase.…”