Speed of remission in elderly patients with depression: Electroconvulsive therapy<i>v</i>. medication

Spaans, Harm-Pieter; Sienaert, Pascal; Bouckaert, Filip; Berg, Julia F. van den; Verwijk, Esmée; Kho, King H.; Stek, Max L.; Kok, Rob M.

doi:10.1192/bjp.bp.114.148213

Cited by 130 publications

(61 citation statements)

References 25 publications

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“…The number of Alzheimer’s patients will be between 11 and 16 million as per AA estimates, with one new event happening every 33 s by 2050 in the United States [27]. Depression, especially unipolar among over 60 year olds, accounts for 5.7% of years lived with disability [24, 28, 29]. It is most commonly seen in developing countries.…”

Section: Introductionmentioning

confidence: 99%

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Spectrum of Disease and Prescription Pattern for Outpatients with Neurological Disorders: An Empirical Pilot Study in Bangladesh

et al. 2017

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Background: Neurological disorders represent one of the most prominent causes of morbidity and mortality that adversely affect the lifestyle of patients and a major percentage of these diseases exists in developing countries. Purpose: The objective of this study was to examine the prevalence and prescription pattern for outpatients with neurological disorders in Bangladesh. Methods: The study was conducted on 1,684 patients in 6 hospitals (National Institute of Neurosciences and Hospital, Dhaka Medical College and Hospital, Bangabandhu Sheikh Mujib Medical University, Shaheed Suhrawardy Medical College, Sir Salimullah Medical College, and Apollo Hospitals Dhaka) of the Dhaka City from March 2014 to June 2015. Data were collected through a predesigned questionnaire from the patients that contain information about gender, age, marital status, occupation, residential status, affected disease, self-medicated medicines, and prescribed medicines. Results: Out of 1,684 patients, 28.38% patients were aged 51–60 years and male, 57.19% predominance. The study exposed headache and migraine for 29.75% patients, followed by stroke for 23.93% patients and seizure for 7.07% patients. Genetic reason for the neurological disorders was seen only among 12.35% patients. In this study, 16.98% patients had been affected by neurological disorders for more than 2 years and 19% of patients for less than 6 months. Most extensively prescribed medicines were multivitamins and multiminerals used by 17.89% of patients followed by nonsteroidal anti-inflammatory drugs and other analgesic by 14.84%; afterwards antiulcerants were used by 12.62%, subsequently anticoagulants were used by 11.61% followed by antihyperlipidemic medicines by 10.26% and antiepileptic drugs by 8.08% of patients. The crucial reasons for the selection of prescribed medicines were the confidence that patients had with the physician’s prescribed medicines, which was shown for 40.97% patients and knowledge of the medicines was reported for 35.04% patients. The period of prescribed medicine usage was 1–3 months for 39.73% patients and 3–6 months for 29.16% patients. The patient’s compliance for prescribed medicines was satisfactory for 34.56% patients, good for 28.15% patients, and side effects were reported for 23.22% patients. Conclusion: In Bangladesh, it is not surprising to note that neurological diseases are more prevalent than other different diseases among different age groups and genders. Headache and migraine, stroke and seizure are most frequently encountered neurological disorders here. Treatment procedure of these disorders is not quite suitable due to the anomalies of health care management systems. Appropriate management of the health care system, especially the placement of hospital and community pharmacy can overcome the existing inconsistencies as well as increase the knowledge, awareness, and perception of the patients about health and neurological disorders.

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Section: Introductionmentioning

confidence: 99%

“…It is most commonly seen in developing countries. According to WHO, unipolar depression is regarded as the 3rd prominent cause of disease burden all over the world [24, 28, 29]. …”

Section: Introductionmentioning

confidence: 99%

Spectrum of Disease and Prescription Pattern for Outpatients with Neurological Disorders: An Empirical Pilot Study in Bangladesh

et al. 2017

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“…A very recent study [24•] reanalyzed subjects aged over 60 from two double blind, controlled trials to compare the speed of remission using ECT versus medication in elderly with MDD but not necessarily with TRD. The first selected trial [25] recruited adult MDD patients and randomized them to twice weekly right unilateral (RUL) brief pulse (1.0 msec) or ultra-brief pulse (0.3–0.37 msec) ECT eight times seizure threshold.…”

Section: Introductionmentioning

confidence: 99%

A Review of Brain Stimulation Treatments for Late-Life Depression

Blumberger

Hsu

Daskalakis

2015

Curr Treat Options Psych

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Opinion Statement Recurrence, relapse and resistance to first-line therapies are common and pervasive issues in the treatment of depression in older adults. As a result, brain stimulation modalities are essential treatment options in this population. The majority of data for the effectiveness of brain stimulation modalities comes from electroconvulsive therapy (ECT) studies. Current ECT trials are focused on prolonging response after a successful course and mitigating the cognitive adverse effects. Newer forms of brain stimulation have emerged; unfortunately, as with most advances in medicine older adults have not been systematically included in clinical trials. Repetitive transcranial magnetic stimulation has demonstrated efficacy in younger adults and there is emerging data to support its use in late-life depression (LLD). It will be imperative that older adults be included in future transcranial direct current stimulation and magnetic seizure therapy clinical trials. Unclear efficacy results are a concern for both vagus nerve stimulation and deep brain stimulation.

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“…However, most patients who were resistant to antidepressant or psychotherapy showed improvement after ECT was introduced. In other words, ECT may have a greater effect than the two routinely used methods in fighting depression (Husain et al, 2004;Spaans et al, 2015;Liang et al, 2017Liang et al, , 2018. Furthermore, the rate of failure in medication or psychotherapy is high and consistent (Schoeyen et al, 2015;Malhi and Mann, 2018).…”

Section: Introductionmentioning

confidence: 99%

Effects of Electroconvulsive Therapy on Depression and Its Potential Mechanism

Yao

Sun

et al. 2020

Front. Psychol.

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Depression is one of the most common disorders causing mortality around the world. Although electroconvulsive therapy (ECT) is, along with antidepressants and psychotherapy, one of the three major treatments of depression, it is still considered as the last resort for depressed patients. This situation is partially due to limited studies and uncertainty regarding its mechanism. However, decades of increased research have focused on the effects of ECT on depression and its potential mechanism. Furthermore, these investigations may suggest that ECT should be a first-line therapy for depression due to its profound effects in relieving desperation in certain situations. Here, we outline recent clinical and preclinical studies and summarize the advantages and disadvantages of ECT. Thus, this review may provide some hints for clinical application.

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Speed of remission in elderly patients with depression: Electroconvulsive therapyv. medication

Abstract: Considering the substantially higher speed of remission, ECT deserves a more prominent position in the treatment of elderly patients with severe depression.

Cited by 130 publications

References 25 publications

Spectrum of Disease and Prescription Pattern for Outpatients with Neurological Disorders: An Empirical Pilot Study in Bangladesh

Spectrum of Disease and Prescription Pattern for Outpatients with Neurological Disorders: An Empirical Pilot Study in Bangladesh

A Review of Brain Stimulation Treatments for Late-Life Depression

Effects of Electroconvulsive Therapy on Depression and Its Potential Mechanism

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