Abstract
Objective: This study was conducted to discern the efficacy of maintenance electroconvulsive therapy (M-ECT) in a population of depressed elderly individuals with treatment-resistant depression. Methodology: Twenty-nine (N = 29) individuals over the age of 65 years of age and older were assigned to a control or treatment group on the basis of their decision to receive M-ECT (treatment group) or to refrain from receiving the treatment (control group). A battery of psychometric tests designed to measure severity of depression, quality of life, and cognition were administered at baseline as well as at 6-month and 1-year intervals. Results: Statistical analysis of the data indicated no significant differences in the efficacy of M-ECT between the control and treatment groups in any of the tests administered during the participation of the study. Conclusion: The results of the study suggest that there is no added benefit for patients administered M-ECT. However, study sample size and availability of alternative treatment regimens for the control group limit generalizability of these findings and warrant further investigation.
Highlights
Patients in treatment for severe depressive disorder are often treated with a combination of pharmacotherapy and psycho-social interventions
Statistical analysis of the data indicated no significant differences in the efficacy of maintenance electroconvulsive therapy (M-Electro Convulsive Therapy (ECT)) between the control and treatment groups in any of the tests administered during the participation of the study
Provided that the sample size in each group was relatively low, our data indicated that there was no significant benefit for the administration of maintenance ECT when patients were followed-up at 6-month and 1-year intervals as evidenced by similar scores on the various cognitive and psychiatric tests employed in the study as well as the insignificant difference in re-admissions for both the control and treatment groups and significant attrition by participants assigned to the treatment group
Summary
Patients in treatment for severe depressive disorder are often treated with a combination of pharmacotherapy and psycho-social interventions. Drug interactions, and poor tolerance to pharmacotherapy complicate the management for successful remission of depression in the elderly population [1]. Electro Convulsive Therapy (ECT) has been used safely within the elderly population with improvement in depression [2] and is often a preferred option for elderly patients with underlying medical conditions or low tolerance to pharmacologicals [3]. There are earlier studies looking at the role of maintenance ECT in the management of severe depression in the elderly. The current body of knowledge is sparse on the incorporation of maintenance-ECT (M-ECT) in the long-term and in combination with a standard maintenance pharmacological regime, though it is recognized as a valuable and underutilized method of treatment [5]
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