530. The influence of age on the response of major depression to electroconvulsive therapy

O’Connor, Katie; Knapp, Rebecca G.; Rummans, Teresa A.; Smith, Glenn E.; Husain, Mustafa M.; Kellner, Charles H.; Beale, Mark D.; Petrides, Georgios; Fink, Max; Rush, A. John; Rasmussen, Keith G.; Snyder, Karen; Bernstein, Hilary J.

doi:10.1016/s0006-3223(00)00800-3

Cited by 41 publications

(61 citation statements)

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“…This is despite the fact that older age was associated with a higher burden of physical illness and greater cognitive impairment at baseline. O'Connor and others found that the higher rate of response among patients aged over 45 years was partly attributable to the greater prevalence of psychotic depression in later life (11). Thus, the superior response to ECT among older patients may not be due to aging per se but to clinical factors that differentiate them from younger patients.…”

Section: Efficacy Of Ect In the Elderlymentioning

confidence: 99%

Effective Use of Electroconvulsive Therapy in Late-Life Depression

Flint

Gagnon

2002

Can J Psychiatry

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Objective: To review literature pertaining to the efficacy, safety, and tolerability of electroconvulsive therapy (ECT) in treating late-life depression. Method:We undertook a literature review with an emphasis on research studies published in the last 10 years.Results: There is a positive association between advancing age and ECT efficacy. Age per se does not necessarily increase the risk of cognitive side effects from ECT, but this risk is increased by age-associated neurological conditions such as Alzheimer's dementia and cerebrovascular disease. With appropriate evaluation and monitoring, ECT can be used safely in patients of very advanced age and in those with serious medical conditions. Several technical factors, including dose of electricity relative to a patient's seizure threshold, position of electrodes, frequency of administration, and total number of treatments, have an impact on the efficacy and cognitive side effects of ECT and need to be taken into account when administering ECT. Naturalistic studies have found that 50% or more of patients have a relapse of depression within 6 to 12 months of discontinuing acute ECT. Conclusions:In recent years, there has been substantial progress in our understanding of the effect of technical factors on the efficacy and cognitive side effects of ECT. When administered in an optimal manner, ECT is a safe, well-tolerated, and effective treatment in older patients. Relapse of depression after response to ECT remains a significant problem, and there is a need for further research into the prediction and prevention of post-ECT relapse. Clinical Implications · With appropriate evaluation and monitoring, electroconvulsive therapy (ECT) is a safe and effective treatment in elderly patients, including those of very advanced age and those with significant medical comorbidity. · Technical factors have a significant impact on the efficacy and side effects of ECT and need to be taken into account when administering the treatment. · Despite the use of continuation antidepressant medication, relapse of depression after ECT remains a significant problem. Limitations· Only 1 study, with a relatively small number of patients, has compared the efficacy and cognitive effects of high-dose right unilateral ECT with bilateral ECT. The findings of this study require replication in a larger group of patients recruited from more than 1 research centre. · The optimal electrical dose for right unilateral ECT remains to be established. · Data pertaining to the efficacy of continuation ECT are derived from uncontrolled or retrospective studies. However, data from the first controlled, prospective study of continuation ECT should soon be available.

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Section: Efficacy Of Ect In the Elderlymentioning

confidence: 99%

Effective Use of Electroconvulsive Therapy in Late-Life Depression

Flint

Gagnon

2002

Can J Psychiatry

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“…2 Older age is associated with a better outcome, with remission rates reaching 73%-90% in patients older than 65 years. 3,4 Electro convulsive therapy has a positive effect on mood, cognition and psychomotor function in elderly patients with depress tion, is considered safe 5,6 and is recommended as a preferen tial treatment for major depression with psychotic features, treatmentresistant depression and acute suicidal ideation. 7 Despite these welldocumented clinical effects in patients with late life depression (LLD), little is known about the brain changes associated with ECT in elderly patients.…”

Section: Introductionmentioning

confidence: 99%

Grey matter volume increase following electroconvulsive therapy in patients with late life depression: a longitudinal MRI study

Bouckaert

Winter

Emsell

et al. 2016

jpn

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“…Their findings suggested a significant association between increasing age and probability of improvement prognosis. A more recently published multicenter study of the Consortium of Research in ECT [CORE;O'Connor et al, 2001] also reports that age is positively associated with the response to bilateral ECT treatment of major depression; remission rates on the Hamilton Rating Scale for Depression [HRSD; Hamilton, 1967] for three age-groups-Z65 years, 46-64 years, and r45 years-were 90.0%, 89.8%, and 70.0%, respectively. Age, as a continuous variable, positively influenced response to treatment [O'Connor et al, 2001].…”

Section: Introductionmentioning

confidence: 99%

Age-related cognitive effects of ECT and ECT-induced mood improvement in depressive patients

Bosboom

Deijen

2006

Depress. Anxiety

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This explorative study investigated the interaction between electroconvulsive therapy (ECT) treatment-effect, reduced depression, and neuropsychological outcome in relation to age. Follow-up neuropsychological assessment was conducted with depressive patients treated with ECT. From a potential sample of 45 patients, the neuropsychological measures (pre-ECT, three times post-ECT, up to 12 months) and clinical data from the remaining 21 patients who completed all assessments were evaluated (mean age 5 56.76; SD 5 14.12; range, 33-79). ECT resulted in a decrease in the depression scores. A distinct impact of ECT and depression decrease on cognitive domains was found. Depression alleviation was mainly associated with improvement in cognitive domains such as memory, information processing, and executive function. ECT improved cognitive domains such as information processing and perception. Short-term cognitive improvement was greater in older patients but showed an increase similar to that at long-term follow-up in younger patients (o60). Current findings provide evidence that ECT may improve cognitive functioning in nondemented elderly, which has strong clinical relevance concerning the use of ECT.

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530. The influence of age on the response of major depression to electroconvulsive therapy

Cited by 41 publications

References 0 publications

Effective Use of Electroconvulsive Therapy in Late-Life Depression

Effective Use of Electroconvulsive Therapy in Late-Life Depression

Grey matter volume increase following electroconvulsive therapy in patients with late life depression: a longitudinal MRI study

Age-related cognitive effects of ECT and ECT-induced mood improvement in depressive patients

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