Electroconvulsive Therapy in Geriatric Psychiatry

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

doi:10.1016/j.psc.2017.10.007

Cited by 23 publications

(14 citation statements)

References 63 publications

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“…The study also observed that improvement in depression was negatively correlated with age, which is consistent with other treatment studies of vascular depression. Additionally, for treatment-resistant or severe cases, the use of electroconvulsive therapy (ECT) is an important means of achieving remission (46). A recent study examined vascular risk factors in elderly inpatients receiving antidepressant management compared to ECT.…”

Section: Treatment Issues: Managementmentioning

confidence: 99%

Perspectives on the Management of Vascular Depression

Taylor

Schultz

Panaite

et al. 2018

AJP

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In the next few years, the youngest of the baby boomers will reach age 65, resulting in the greatest proportion of elderly adults in US history. Concurrent with this demographic change is the growing number of adults living with chronic conditions that increase risk of vascular disease, including hypertension, obesity, hypercholesterolemia, insulin resistance and diabetes mellitus. We address how these conditions contribute to age-related cerebrovascular changes and lead to subsequent effects on mood and cognitive function, with an emphasis on the role of “vascular depression” as a focus of treatment. The case of an elderly gentleman with vascular disease associated with psychiatric symptoms and cognitive changes is presented. We discuss vascular depression in the context of suicide in late life and provide perspectives on treatment that focus not merely on pharmacologic and psychotherapeutic management of depressive symptoms but also emphasize the importance of sleep and health maintenance strategies. Guidelines are offered to help reduce the burden of disability associated with this condition among our older population.

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Section: Treatment Issues: Managementmentioning

confidence: 99%

Perspectives on the Management of Vascular Depression

Taylor

Schultz

Panaite

et al. 2018

AJP

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“…Data have shown that ECT is safe in older adults despite medical comorbidities and is highly effective in treating severe psychiatric illnesses such as major depressive disorder, psychosis, mania, and behavioral symptoms of dementia. 3 , 4 Disruption in the acute course of ECT in the absence of adverse events would be harmful for older patients, potentially precipitating clinical decline.…”

Section: Introductionmentioning

confidence: 99%

Electroconvulsive Therapy Practice Changes in Older Individuals Due to COVID-19: Expert Consensus Statement

Lapid

Seiner

Heintz

et al. 2020

The American Journal of Geriatric Psychiatry

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Highlights What is the primary question addressed by this study? How have ECT practices changed to adapt to public health guidelines for treating older adults amidst the coronavirus 2019 (COVID-19) pandemic? What is the main finding of this study? Electroconvulsive therapy (ECT) continues to be an essential treatment for older adults with severe mental illness, and extensive infection control and public health measures are being taken to mitigate risk of transmission while sustaining operations. What is the meaning of the finding? Substantial changes to ECT practices are anticipated to be long-standing and will likely evolve further in response to availability of testing and treatment for COVID-19.

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“…The efficacy of ECT in the older patients was higher than in the younger age groups [ 26 , 30 , 31 , 32 , 33 , 34 , 35 ]. Recent reviews and meta-analyses also seem to support these findings [ 27 , 28 , 36 ]. Nevertheless, not all researchers agree on this.…”

Section: Discussionmentioning

confidence: 80%

Electroconvulsive Therapy and Age: Effectiveness, Safety and Tolerability in the Treatment of Major Depression among Patients under and over 65 Years of Age

et al. 2021

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Electroconvulsive therapy (ECT) remains the most effective therapy in treatment-resistant depression. However, the safety of ECT has been consistently questioned, particularly among elderly patients. We assessed the efficacy and safety of ECT in patients before and after 65 years old. The study was conducted between 2015 and 2018 and included 91 patients (61 under and 29 over 65 years old) with major depression undergoing ECT. The Hamilton Depression Rating Scale was used to evaluate efficacy. Cognitive functions were assessed using: MMSE, RAVLT, Trail Making Test, Stroop Test and Autobiographical Memory Interview-Short Form. ECT was more effective in older patients as compared to younger (p < 0.001). No serious adverse events were observed in either group. Increased blood pressure and arrhythmias were more common in the older compared to the younger group (p = 0.044 and p = 0.047, respectively), while disturbances of consciousness did not differ between groups (p = 0.820). Most of the cognitive functions remained unchanged compared to baseline, whereas the outcomes of MMSE, RAVLT and Stroop tests showed greater improvements in the older compared to the younger group (all p < 0.05). The decline in the retrieval consistency of autobiographical memory was more pronounced in the younger group (p = 0.024). ECT is a highly effective, safe and well-tolerated method of treating depression regardless of age.

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Electroconvulsive Therapy in Geriatric Psychiatry

Cited by 23 publications

References 63 publications

Perspectives on the Management of Vascular Depression

Perspectives on the Management of Vascular Depression

Electroconvulsive Therapy Practice Changes in Older Individuals Due to COVID-19: Expert Consensus Statement

Electroconvulsive Therapy and Age: Effectiveness, Safety and Tolerability in the Treatment of Major Depression among Patients under and over 65 Years of Age

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