Electroconvulsive Therapy in Geriatric Psychiatry

Meyer, Justin P.; Swetter, Samantha; Kellner, Charles H.

doi:10.1016/j.cger.2019.11.007

Cited by 24 publications

(22 citation statements)

References 63 publications

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“…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 …”

Section: Discussionsupporting

confidence: 92%

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

et al. 2021

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Background Electroconvulsive therapy (ECT) remains the most effective treatment of depression in the elderly population; however, it is still unclear which type of ECT is most beneficial in this population. The aims of this study were: (i) to assess the feasibility of a randomised controlled trial in elderly depressed patients treated with right unilateral (RUL) or fronto‐temporal bilateral (BT) formula‐based ECT; (ii) to compare formula‐based RUL and BT ECT in terms of efficacy, safety and tolerability in this population. Methods The study lasted 3 years and managed to randomise 29 patients over 65 years old to receive either BT (n = 14) or RUL (n = 15) ECT. Brief pulse width (0.5 ms) and age‐based dosing method were applied. The clinical efficacy was assessed using Hamilton Depression Rating Scale, somatic state was monitored throughout the ECT course. In neuropsychological examination general cognitive performance, executive functions, verbal fluency, memory, autobiographical memory were evaluated. Results The recruitment was poor due to small number of patients able to give informed consent. ECT proved to be a highly effective and safe method of treatment among elders. Formula‐based RUL ECT did not differ from BT in antidepressant efficacy and had cognitive advantages ‐ the indices of general cognitive performance, verbal fluency and memory were significantly better than before the treatment in the RUL group. Decline in retrieval consistency of autobiographical memory was more pronounced in the BT group, although it was observed across both groups. Conclusions Formula‐based RUL ECT might not differ from BT in antidepressant efficacy and has an advantage in terms of tolerability.

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Section: Discussionsupporting

confidence: 92%

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

et al. 2021

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“…More recent literature, however, provides strong support for its use in acute depression and as maintenance treatment (Geduldig and Kellner, 2016; Kellner et al, 2016a, 2016b). A recent review of ECT in the elderly (Meyer et al, 2018) concluded that it was a safe and effective treatment in this age group, that the cognitive side effects are transient, and that it does not worsen dementia.…”

Section: Treatmentsmentioning

confidence: 99%

The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders

Malhi

Bell

Bassett³

et al. 2020

Aust N Z J Psychiatry

343

365

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Objectives: To provide advice and guidance regarding the management of mood disorders, derived from scientific evidence and supplemented by expert clinical consensus to formulate s that maximise clinical utility. Methods: Articles and information sourced from search engines including PubMed, EMBASE, MEDLINE, PsycINFO and Google Scholar were supplemented by literature known to the mood disorders committee (e.g. books, book chapters and government reports) and from published depression and bipolar disorder guidelines. Relevant information was appraised and discussed in detail by members of the mood disorders committee, with a view to formulating and developing consensus-based recommendations and clinical guidance. The guidelines were subjected to rigorous consultation and external review involving: expert and clinical advisors, key stakeholders, professional bodies and specialist groups with interest in mood disorders. Results: The Royal Australian and New Zealand College of Psychiatrists mood disorders clinical practice guidelines 2020 (MDcpg2020) provide up-to-date guidance regarding the management of mood disorders that is informed by evidence and clinical experience. The guideline is intended for clinical use by psychiatrists, psychologists, primary care physicians and others with an interest in mental health care. Conclusion: The MDcpg2020 builds on the previous 2015 guidelines and maintains its joint focus on both depressive and bipolar disorders. It provides up-to-date recommendations and guidance within an evidence-based framework, supplemented by expert clinical consensus. Mood disorders committee: Gin S Malhi (Chair), Erica Bell, Darryl Bassett, Philip Boyce, Richard Bryant, Philip Hazell, Malcolm Hopwood, Bill Lyndon, Roger Mulder, Richard Porter, Ajeet B Singh and Greg Murray.

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“…In this challenging time, the need to deliver care for older adults experiencing serious mental illness is higher than ever. ECT not only yields high remission rates in older patients, 3 it is often life-saving in patients refusing food and fluid intake, or those with psychotic depression, catatonia, and suicidality. 4 In considering the implications of COVID-19 for ECT, it is important for psychiatrists to carefully review the treatment needs in consultation with patients and their families.…”

Section: Our Patients Cannot Waitmentioning

confidence: 99%