Electroconvulsive therapy for older adult patients with major depressive disorder: a systematic review of randomized controlled trials

Abstract

This systematic review showed that ECT appears to be an effective and safe treatment for older adult patients with major depressive disorder. Further high-quality studies with extended follow-up are warranted.

Right unilateral versus bilateral formula‐based electroconvulsive therapy in the treatment of major depression in elderly patients: a randomised, open label, pilot controlled trial

“…Overall, no serious adverse events were reported during the course of the study. This is consistent with the literature reviews indicating the safety of ECT in elderly patients 5, 11,38–40 …”

“…Electroconvulsive therapy (ECT) appears to be much more efficient treatment in elderly patients wherein pharmacotherapy is often poorly tolerated or ineffective. A review of randomised controlled trials comparing ECT and pharmacotherapy in the population of older patients indicated ECT therapy as more effective ‐ the response rates were 80–97% versus 63–73% among patients treated with ECT and pharmacotherapy, respectively 5 . ECT has been proven to be an effective method of treatment even in cases of co‐occurrence of somatic diseases, vascular or neurodegenerative lesions in the brain 6,7 .…”

“…A review of randomised controlled trials comparing ECT and pharmacotherapy in the population of older patients indicated ECT therapy as more effective -the response rates were 80-97% versus 63-73% among patients treated with ECT and pharmacotherapy, respectively. 5 ECT has been proven to be an effective method of treatment even in cases of co-occurrence of somatic diseases, vascular or neurodegenerative lesions in the brain. 6,7 It has also been shown that coexisting cognitive impairments do not affect the effectiveness of ECT.…”

“…The cognitive side effects of ECT have been consistently called into question, particularly given the associated memory impairment. Although ECT appears to be a safe method of treatment, 5,[10][11][12] some patients report about their memory problems even a long time after the treatment. This issue raises concerns especially among elderly patients due to at least two reasons: (1) cognitive impairment is a common symptom of late-life depression and (2) older people have an increased risk of dementia.…”

Subanesthetic dose of ketamine for the antidepressant effects and the associated cognitive impairments of electroconvulsive therapy in elderly patients—A randomized, double‐blind, controlled clinical study

“…A large number of clinical studies have confirmed that although their curative effect is accurate, it is limited by the slow onset and low efficiency. Compared with the curative effect of drug therapies, electroconvulsive therapy (ECT) for depression has a higher efficiency rate and quicker onset (Dong et al., 2018; Rhebergen et al., 2015), especially after the introduction of anesthetics and muscle relaxants used during the procedure. The modified ECT not only eliminates the patients' fear and reduces the stress response, but also has been widely used worldwide as it reduces the incidence of adverse events, such as fracture, tooth injury, and cardiovascular and cerebrovascular accidents.…”