Influence of Age on Effectiveness and Tolerability of Electroconvulsive Therapy

Damm, Julia; Eser, Daniela; Schüle, Cornelius; Obermeier, Michael; Möller, H.-J.; Rupprecht, Rainer; Baghai, Thomas C.

doi:10.1097/yct.0b013e3181cadbf5

Cited by 53 publications

(30 citation statements)

References 26 publications

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“…Furthermore, a large age range (23-81 yr) of the present sample including elderly patients has to be acknowledged with a significantly better response to ECT in older patients, which is in line with a multi-site longitudinal study (CORE) showing older age to confer a greater likelihood of achieving remission under ECT (O'Connor et al 2001) and another study reporting even the oldest depressed patients to respond to ECT equally well or even better than younger patients (Tew et al 1999). However, several other studies failed to demonstrate an influence of age on ECT effectiveness (Birkenhäger et al 2010 ;Damm et al 2010). Finally, taking into account the OR usually found by pharmacogenetic studies in major depression, the power of the present study to detect associations with remission is quite low.…”

Section: Discussioncontrasting

confidence: 50%

Dopamine D3 receptor gene variation: impact on electroconvulsive therapy response and ventral striatum responsiveness in depression

Dannlowski

Domschke

Birosova

et al. 2013

International Journal of Neuropsychopharmacology

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Dysfunction of dopamine D₃ receptors, particularly in the mesocorticolimbic system, has been linked to the pathogenesis of major depression. Preclinical data show enhanced D₃ receptor binding in the striatum upon antidepressant medication and electroconvulsive therapy (ECT). Thus, the potential impact of dopamine D₃ receptor gene (DRD3) variation on ECT outcome in treatment-resistant major depression was evaluated by applying a combined molecular and imaging genetic approach. Altogether, 10 representative variants covering 95.4% of DRD3 gene variation were investigated for association with response to ECT in a sample of 104 (71 female, 33 male) Caucasian patients with pharmacorefractory major depression. Additionally, ventral striatum responsiveness to happy faces was assessed in two independent samples of depressed patients (total N=54) by means of functional magnetic resonance imaging at 3 T. Significant association of DRD3 rs3732790, rs3773679 and rs9817063 variants with response (uncorrected p=0.02-0.03) and remission (uncorrected p=0.01) after ECT was discerned. Logistic regression analyses revealed association of rs3732790 (uncorrected p=0.009; corrected p=0.045) and rs3773679 (uncorrected p=0.009; corrected p=0.045) with remission when applying a recessive model of inheritance. The rs3732790T allele conferring a more favourable treatment response was furthermore found to be associated with stronger striatal responsiveness to happy facial expressions (sample 1: cluster-corrected p=0.002; sample 2: p=0.023). In summary, the present study suggests some impact of DRD3 gene variation on ECT response, potentially mediated by alteration of striatal engagement during the processing of emotionally rewarding stimuli.

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Section: Discussioncontrasting

confidence: 50%

Dopamine D3 receptor gene variation: impact on electroconvulsive therapy response and ventral striatum responsiveness in depression

Dannlowski

Domschke

Birosova

et al. 2013

International Journal of Neuropsychopharmacology

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“…In our cohort, no complaints about being awake before seizure induction were reported by patients. Our data showed that "age" was negatively correlated with all seizure parameters except EEG seizure activity duration, however, ECT is known to be very eff ective for patients of all age groups [ 22 ] . Refi ning our model with age-dependent cut-off s for all parameters, not only with cut-off s for seizure duration and peak heart rate, thus seems necessary.…”

mentioning

confidence: 93%

Bispectral Index Monitoring and Seizure Quality Optimization in Electroconvulsive Therapy

et al. 2013

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In ECT, the relative timing of seizure induction and anesthesia may critically impact on seizure quality when anesthetic agents with anticonvulsive properties such as barbiturates or propofol are used. Measuring the depth of anesthesia by bispectral index (BIS) monitoring and thereby identifying the optimal moment for seizure induction might enhance seizure quality.Seizures from 869 individual ECT -sessions with thiopental anesthetic from 118 patients were examined in this retrospective study. The associations of the BIS value at the moment of seizure induction with 7 established seizure parameters and with a novel model of seizure quality were tested by regression analyses.BIS value at induction correlated positively with seizure duration, central inhibition, coherence and maximal heart rate, but not with midictal amplitude. Higher seizure quality was related with a higher BIS value at the moment of seizure induction.The BIS value at seizure induction serves as an independent predictor of seizure quality, influencing most other established markers. BIS monitoring appears as a simple tool to identify the optimal moment for seizure induction.

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“…This difference could be because of the differences in the population demographics than the deliberate exclusion of elderly patients from ECT referrals [8]. A study conducted by Damm et al, confirmed the effectiveness of ECT irrespective of age [9]. Though not contraindicated, ECT is not commonly used in extremes of age.…”

Section: Resultsmentioning

confidence: 86%

Use of ECT in Nepal: A One Year Study From the Country’s Largest Psychiatric Facility

Subedi

Aich

Sharma

2016

JCDR

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Influence of Age on Effectiveness and Tolerability of Electroconvulsive Therapy

Abstract: Our data confirm previous studies indicating the good effectiveness of ECT irrespective of age. We also found an excellent tolerability profile in the elderly in our patient sample. There was no mortality, and only transient and no life-threatening adverse events occurred.

Cited by 53 publications

References 26 publications

Dopamine D3 receptor gene variation: impact on electroconvulsive therapy response and ventral striatum responsiveness in depression

Dopamine D3 receptor gene variation: impact on electroconvulsive therapy response and ventral striatum responsiveness in depression

Bispectral Index Monitoring and Seizure Quality Optimization in Electroconvulsive Therapy

Use of ECT in Nepal: A One Year Study From the Country’s Largest Psychiatric Facility

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