The efficacy and safety of ECT in depressed older adults: a literature review

Although little doubt exists among practising clinicians in old age psychiatry about the efficacy and safety of ECT in depression, opinions about acceptability differ widely. The objectives of this review were to determine the efficacy and safety of ECT based on both randomised and non‐randomised evidence in elderly with a major depressive disorder.

[1]  P. Doraiswamy,et al.  Subcortical Structural Changes in ECT-Induced Delirium , 1990, Journal of geriatric psychiatry and neurology.

[2]  C. Lyketsos,et al.  The benefits and risks of ECT for patients with primary dementia who also suffer from depression , 2000, International journal of geriatric psychiatry.

[3]  J. Hewitt,et al.  Prolonged hypertension: A case report of a potential interaction between electroconvulsive therapy and venlafaxine. , 1999, International journal of psychiatry in clinical practice.

[4]  R. Dolan,et al.  ECT and cerebral atrophy , 1981, Acta psychiatrica Scandinavica.

[5]  D. Casey,et al.  Electroconvulsive therapy in the very old. , 1996, General hospital psychiatry.

[6]  D. Wilkinson,et al.  Depression in old age: Prognosis after ECT , 1987 .

[7]  L. Gustafson,et al.  Barriers to the use of electroconvulsive therapy in the elderly: a European survey , 2002, European Psychiatry.

[8]  P. Kettl,et al.  Incidence of asystole in electroconvulsive therapy in elderly patients. , 1998, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[9]  E. Cybulska Globus Hystericus-A Somatic Symptom of Depression? The Role of Electroconvulsive Therapy and Antidepressants , 1997, Psychosomatic medicine.

[10]  J. Davis,et al.  Improvement of depression and parkinsonism during ECT: a case study. , 1976, Neuropsychobiology.

[11]  C. Katona Psychotropics and drug interactions in the elderly patient , 2001, International journal of geriatric psychiatry.

[12]  A. Beekman,et al.  Minor and major depression and the risk of death in older persons. , 1999, Archives of general psychiatry.

[13]  K. Shulman,et al.  The Clinical Use of Electroconvulsive Therapy in Old Age , 1984, Journal of the American Geriatrics Society.

[14]  M. Dysken,et al.  ECT, emergent dyskinesia, and depression. , 1984, The American journal of psychiatry.

[15]  D. O'Leary,et al.  Seven Year Prognosis in Depression , 1996, British Journal of Psychiatry.

[16]  Allen Rm Pseudodementia and ECT. , 1982 .

[17]  J. Yesavage,et al.  Multiple Monitored Electroconvulsive Therapy in the Elderly † , 1980, Journal of the American Geriatrics Society.

[18]  A. Stoudemire,et al.  Rehospitalization Rates in Older Depressed Adults After Antidepressant and Electroconvulsive Therapy Treatment , 1994, Journal of the American Geriatrics Society.

[19]  A. Stoudemire,et al.  Long-term affective and cognitive outcome in depressed older adults. , 1993, The American journal of psychiatry.

[20]  C. McCracken,et al.  DOES AGE PREDICT THE LONG‐TERM OUTCOME OF DEPRESSION TREATED WITH ECT? (A PROSPECTIVE STUDY OF THE LONG‐TERM OUTCOME OF ECT‐TREATED DEPRESSION WITH RESPECT TO AGE) , 1997, International journal of geriatric psychiatry.

[21]  A. Aisen,et al.  A preliminary magnetic resonance imaging study of ECT-treated depressed patients , 1990, Biological Psychiatry.

[22]  P. D. Morris,et al.  Which elderly depressives will respond to ECT? , 1991 .

[23]  R. Lam,et al.  ECT in the Treatment of Mixed Depression and Dementia , 1988, British Journal of Psychiatry.

[24]  G. Figiel,et al.  Prospective uses of ECT in the presence of intracranial tumors. , 1991, The Journal of neuropsychiatry and clinical neurosciences.

[25]  David J. Gill,et al.  The Nottingham ECT Study , 1985, British Journal of Psychiatry.

[26]  P. Blackburn,et al.  Is ect safe in patients with cerebrovascular disease? , 1994 .

[27]  V. Jampala,et al.  Electroconvulsive Therapy in Parkinsonism with Affective Disorder , 1988, British Journal of Psychiatry.

[28]  K. Krishnan,et al.  ECT-induced delirium in depressed patients with Parkinson's disease. , 1991, The Journal of neuropsychiatry and clinical neurosciences.

[29]  A. Wilkinson,et al.  Age and the effects of ect , 1993 .

[30]  D. Gaspar,et al.  ECT in psychogeriatric practice--a study of risk factors, indications and outcome. , 1982, Comprehensive psychiatry.

[31]  Currier Mb,et al.  Electroconvulsive therapy for post-stroke depressed geriatric patients. , 1992 .

[32]  T. Cooper,et al.  Dr. Douyon and Associates Reply , 1989 .

[33]  L. Guttmacher,et al.  Epidemiologic considerations in electroconvulsive therapy. , 1984, Archives of general psychiatry.

[34]  I. Hickie,et al.  A prospective follow-up study of ECT outcome in older depressed patients. , 2000, Journal of affective disorders.

[35]  B. Mulsant,et al.  Impact of acute psychiatric inpatient treatment on major depression in late life and prediction of response. , 1994, The American journal of psychiatry.

[36]  G. Alexopoulos,et al.  Dissociation of motor response from mood and cognition in a Parkinsonian patient treated with ECT , 1985, Biological Psychiatry.

[37]  M. Szuba,et al.  ECT and intracranial vascular masses. , 2000, The journal of ECT.

[38]  S. Yudofsky Parkinson's disease, depression, and electroconvulsive therapy: a clinical and neurobiologic synthesis. , 1979, Comprehensive psychiatry.

[39]  M. Philpot,et al.  The safety and efficacy of electroconvulsive therapy in patients over age 75 , 1998, International journal of geriatric psychiatry.

[40]  Vincent Fm,et al.  Yawning as a complication of electroconvulsive therapy and concurrent neuroleptic withdrawal. , 1988 .

[41]  B. Mulsant,et al.  A Prospective Naturalistic Study of Electroconvulsive Therapy in Late-Life Depression , 1991, Journal of geriatric psychiatry and neurology.

[42]  A. Burns,et al.  Is subcortical disease associated with a poor response to antidepressants? Neurological, neuropsychological and neuroradiological findings in late-life depression , 1998, Psychological Medicine.

[43]  J. Goethe,et al.  Multiple‐monitored Electroconvulsive Therapy: Safety and Efficacy in Elderly Depressed Patients , 1984, Journal of the American Geriatrics Society.

[44]  R. Baldessarini,et al.  Intoxication associated with lithium and ECT. , 1980, The American journal of psychiatry.

[45]  J. O'Brien,et al.  Time Course of Response to Electroconvulsive Therapy in Elderly Depressed Subjects , 1997, International journal of geriatric psychiatry.

[46]  C. Wijeratne,et al.  Electroconvulsive therapy and subdural hemorrhage. , 1999, The journal of ECT.

[47]  G. Grossberg,et al.  Safety and Efficacy of Caffeine-Augmented ECT in Elderly Depressives: A Retrospective Study , 1995, Journal of geriatric psychiatry and neurology.

[48]  D. Kupfer,et al.  Open-trial response to antidepressant treatment in elderly patients with mixed depression and cognitive impairment , 1987, Psychiatry Research.

[49]  G. Alexopoulos,et al.  Medical Problems of Geriatric Psychiatric Patients and Younger Controls During Electroconvulsive Therapy , 1984, Journal of the American Geriatrics Society.

[50]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[51]  A. Stoudemire,et al.  Cognitive outcome following tricyclic and electroconvulsive treatment of major depression in the elderly. , 1991, The American journal of psychiatry.

[52]  E. Rubin,et al.  Electroconvulsive therapy in the treatment of combined depression and Parkinson's disease. , 1988, Psychosomatics.

[53]  W. Burke,et al.  The Safety of ECT in Geriatric Psychiatry , 1987, Journal of the American Geriatrics Society.

[54]  I. B. Glass,et al.  Recovery from ECT in Elderly Patients , 1978, British Journal of Psychiatry.

[55]  Pettinati Hm,et al.  Cognitive functioning in depressed geriatric patients with a history of ECT. , 1984 .

[56]  P. Doraiswamy,et al.  Brain magnetic resonance imaging findings in ECT-induced delirium. , 1990, The Journal of neuropsychiatry and clinical neurosciences.

[57]  B. Meyers,et al.  Empirical Study on an Inpatient Psychogeriatric Unit: Biological Treatment in Patients with Depressive Illness , 1986, International journal of psychiatry in medicine.

[58]  E. Rubin,et al.  The Nature and Time Course of Cognitive Side Effects During Electroconvulsive Therapy in the Elderly , 1993, Journal of geriatric psychiatry and neurology.

[59]  A. Beekman,et al.  Electroconvulsietherapie in de behandeling van depressie bij ouderen , 1997 .

[60]  S. Hunt,et al.  ECT in the presence of a cerebral aneurysm. , 1998, The journal of ECT.

[61]  S. Benbow The use of electroconvulsive therapy in old age psychiatry , 1987 .

[62]  G. Figiel,et al.  ECT-Induced Interictal Delirium in Patients With a History of a CVA , 1992, Journal of geriatric psychiatry and neurology.

[63]  R. Bloch,et al.  Electroconvulsive therapy in old-old patients. , 2000, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[64]  C. Coffey,et al.  White matter hyperintensity on magnetic resonance imaging: clinical and neuroanatomic correlates in the depressed elderly. , 1989, The Journal of neuropsychiatry and clinical neurosciences.

[65]  T. Rummans,et al.  Safety and efficacy of electroconvulsive therapy in patients over age 85. , 1997, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[66]  J. Markowitz,et al.  Cardiovascular morbidity in high-risk patients during ECT. , 1994, The American journal of psychiatry.

[67]  J. Herzberg,et al.  Length of hospital stay and the timing of ECT , 1995 .

[68]  I. Hickie,et al.  "Side effects" of ECT are mainly depressive phenomena and are independent of age. , 2001, Journal of affective disorders.

[69]  M. Pachter,et al.  Myocardial infarction and fatal coronary insufficiency during electroconvulsive therapy. , 1968, JAMA.

[70]  B. Mulsant,et al.  A pilot study of interictal cognitive changes in elderly patients during ECT , 1992 .

[71]  D. O'Leary,et al.  The effectiveness of real versus simulated electroconvulsive therapy in depressed elderly patients , 1994 .

[72]  I. B. Glass,et al.  Unilateral and bilateral ECT in elderly patients A COMPARATIVE STUDY , 1980, Acta psychiatrica Scandinavica.

[73]  E. A. Brown,et al.  Cognitive performance as modified by age and ECT history , 1993, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[74]  G. Alexopoulos,et al.  'Vascular depression' hypothesis. , 1997, Archives of general psychiatry.

[75]  D. Reboussin,et al.  Comparison of the Efficacy of Titrated, Moderate-Dose and Fixed, High-Dose Right Unilateral ECT in Elderly Patients. , 1995, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[76]  A. Flint,et al.  The treatment of psychotic depression in later life: a comparison of pharmacotherapy and ECT , 1998, International journal of geriatric psychiatry.

[77]  D. Avery,et al.  Mortality in depressed patients treated with electroconvulsive therapy and antidepressants. , 1976, Archives of general psychiatry.

[78]  D. Dighe-Deo,et al.  Electroconvulsive therapy in patients with long bone fractures. , 1998, The journal of ECT.

[79]  L. Levy,et al.  Parkinsonism: improvement by electroconvulsive therapy. , 1983, Archives of physical medicine and rehabilitation.

[80]  I. Hickie,et al.  Subcortical hyperintensities on magnetic resonance imaging: Clinical correlates and prognostic significance in patients with severe depression , 1995, Biological Psychiatry.

[81]  L. Weisberg,et al.  Intracerebral hemorrhage following electroconvulsive therapy , 1991, Neurology.

[82]  B. A. Kramer Electroconvulsive Therapy Use in Geriatric Depression , 1987, The Journal of nervous and mental disease.

[83]  R. Michels,et al.  Elektrokrampftherapie bei therapieresistenter Altersdepression Ein Erfahrungsbericht , 1998, Der Nervenarzt.

[84]  M. Silverman,et al.  Electroconvulsive Therapy in Octogenarians , 1990, Journal of the American Geriatrics Society.

[85]  B. Fogel,et al.  Electroconvulsive Therapy for Major Depression in the Oldest Old: Effects of Medical Comorbidity on Post-Treatment Survival. , 1993, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[86]  K. Krishnan,et al.  Electroconvulsive therapy of depression in patients with white matter hyperintensity , 1987, Biological Psychiatry.

[87]  C. Coffey,et al.  Leukoencephalopathy in elderly depressed patients referred for ECT , 1988, Biological Psychiatry.