Electroconvulsive therapy in the elderly: Retrospective analysis from an urban general hospital psychiatry unit

Abstract

Introduction: The number of elder patients with severe psychiatric illnesses other than depression is increasing. Electroconvulsive therapy (ECT) has a special role in the treatment of late-life depression and other psychiatric conditions in the elderly. Using ECTs in the elderly could be difficult. In an Indian setting, ECT in the geriatric population is used as last resort of treatment which is in contrast to Western countries. There is dearth of data available for the use of ECT in the elderly in India. Methodology: Retrospective data review was carried out to identify patients 55 years or older who had received ECT from January 2014 to June 2016 in tertiary care teaching hospital in a metropolitan city in India. Results: A total of 304 ECTs were administered to 25 elderly aged >55 years with average of 12 ECTs per patient. Schizophrenia (56%) was the most common diagnosis among patients who were considered for ECT, and this was followed by major depression without psychotic features (24%) and major depression with psychotic features (8%). The most common indication to start ECT was nonresponsiveness to medications (92%). There was an increase in mean Mini-Mental State Examination (MMSE) scores from baseline (23.42) to the end of the sixth (24.60) and last ECT (24.60). Duration of current used during ECT had positive correlation with MMSE. Patients with comorbid medical illness (20%) received ECT without any complication. Conclusions: This study adds to scarce database on the use of ECT in old-age patients in India and adds to evidence that ECT is safe and effective treatment in old age with no negative impact on cognition.