The effectiveness of real versus simulated electroconvulsive therapy in depressed elderly patients

O’Leary, Denis; Gill, David; Gregory, Susan; Shawcross, Charles R.

doi:10.1002/gps.930090711

Cited by 19 publications

(6 citation statements)

References 17 publications

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“…Review of effectiveness: From two reviews, 15 , 16 four RCTs were located. The only study that compared ECT with placebo (sham ECT) in older people 17 showed that ECT was effective. ECT has been widely used to treat severe depression in older people, and retrospective studies have concluded that it is reasonably safe to use, even in patients aged over 80 years 14 .…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of treatments for depression in older people

Frazer

Christensen

Griffiths

2005

Medical Journal of Australia

111

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Objective: To conduct a systematic review of the evidence for the effectiveness of a range of possible treatments for depression in older people. Data sources: Literature search using the PubMed, PsycInfo and Cochrane Library databases. Data synthesis: Treatments that have been suggested to be effective for depression were grouped under three categories: medical treatments, psychological treatments, and lifestyle changes/alternative treatments. We describe each treatment, review the studies of its effectiveness in people aged ≥ 60 years, and give a rating of the level of evidence. Conclusions: The treatments with the best evidence of effectiveness are antidepressants, electroconvulsive therapy, cognitive behaviour therapy, psychodynamic psychotherapy, reminiscence therapy, problem‐solving therapy, bibliotherapy (for mild to moderate depression) and exercise. There is limited evidence to support the effectiveness of transcranial magnetic stimulation, dialectical behaviour therapy, interpersonal therapy, light therapy (for people in nursing homes or hospitals), St John's wort and folate in reducing depressive symptoms.

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Section: Resultsmentioning

confidence: 99%

Effectiveness of treatments for depression in older people

Frazer

Christensen

Griffiths

2005

Medical Journal of Australia

111

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“…ECT is a highly effective treatment for late‐life depression, 147 and may have a more rapid therapeutic effect than drug therapy 148 . However, because of the need for general anesthesia and adverse events such as amnesia, ECT is used only when patients have severe suicidal ideation, undernutrition, or difficulties with antidepressant treatment.…”

Section: Section C Treatmentmentioning

confidence: 99%

Guidelines for diagnosis and treatment of depression in older adults: A report from the Japanese Society of mood disorders

Baba

Kito

Nukariya

et al. 2022

Psychiatry Clin Neurosci

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The Committee for Treatment Guidelines of Mood Disorders, Japanese Society of Mood Disorders, published a Japanese guideline for the treatment of late‐life depression in 2020. Based on that guideline, the present guideline was developed and revised to incorporate the suggestions of global experts and the latest published evidence. In the diagnosis of late‐life depression, it is important to carefully differentiate it from bipolar disorders, depressive states caused by physical and organic brain disease, drug effects, and dementia, and to determine the comorbidity between late‐life depression and dementia. It is necessary to fully understand the clinical characteristics and psychosocial background of late‐life depression, evaluate the patient's condition, and provide basic interventions based on these factors. Problem‐solving therapy, reminiscence therapy/life review therapy, and behavioral activation therapy, and other forms of psychotherapy can reduce depressive symptoms. In terms of pharmacotherapy, newer antidepressants or non‐tricyclic antidepressants are recommended for late‐life depression, and it is recommended that the efficacy of least the minimal effective dosage should first be determined. Switching antidepressants and aripiprazole augmentation can be used to treatment‐resistant therapy. Electroconvulsive therapy and repetitive transcranial magnetic stimulation have demonstrated usefulness for late‐life depression. Exercise therapy, high‐intensity light therapy, and diet therapy also show some effectiveness and are useful for late‐life depression. Continuation therapy should be maintained for at least 1 year after remission.

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“…ECT has an important role in depression with suicidality and psychosis. [64][65][66] Vagal nerve stimulation and transcranial magnetic stimulation are two other therapies for pharmacotherapy-resistant depression, FDA-approved in 2005 and 2008, respectively. 59…”

Section: Treatment-resistant Lld: Pharmacological Strategiesmentioning

confidence: 99%

Applications of magnetic resonance imaging for treatment-resistant late-life depression

Agudelo

Aizenstein

et al. 2015

Dialogues in Clinical Neuroscience

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Late-life depression (LLD) is a growing public and global health concern with diverse clinical manifestations and etiology. This literature review summarizes neuroimaging findings associated with depression in older adults and treatment-response variability. LLD has been associated with cerebral atrophy, diminished myelin integrity, and cerebral lesions in frontostriatal-limbic regions. These associations help explain the depression-executive dysfunction syndrome observed in LLD, and support cerebrovascular burden as a pathogenic mechanism. Furthermore, this review suggests that neuroimaging determinants of treatment resistance also reflect cerebrovascular burden. Of the theoretical etiologies of LLD, cerebrovascular burden may mediate treatment resistance. This review proposes that neuroimaging has the potential for clinical translation. Controlled trials may identify neuroimaging biomarkers that may inform treatment by identifying depressed adults likely to remit with pharmacotherapy, identifying individualized therapeutic dose, and facilitating earlier treatment response measures. Neuroimaging also has the potential to similarly inform treatment response variability from treatment with aripiprazole (dopamine modulator) and buprenorphine (opiate modulator).

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The effectiveness of real versus simulated electroconvulsive therapy in depressed elderly patients

Cited by 19 publications

References 17 publications

Effectiveness of treatments for depression in older people

Effectiveness of treatments for depression in older people

Guidelines for diagnosis and treatment of depression in older adults: A report from the Japanese Society of mood disorders

Applications of magnetic resonance imaging for treatment-resistant late-life depression

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