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The efficacy and safety of ECT in depressed older adults: a literature review
Author(s) -
van der Wurff F. B.,
Stek M. L.,
Hoogendijk W. J. G.,
Beekman A. T. F.
Publication year - 2003
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.944
Subject(s) - electroconvulsive therapy , depression (economics) , dementia , psychiatry , medicine , vascular dementia , major depressive disorder , randomized controlled trial , psychology , disease , schizophrenia (object oriented programming) , mood , economics , macroeconomics
Background 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. Methods Randomised and non‐randomised studies on efficacy and safety of ECT in elderly with and without concomitant disorders such as cerebrovascular disorders, Alzheimer's dementia, vascular dementia and Parkinson's disease were selected. Literature was systematically searched in a number of electronic databases. Results Although 121 studies were included in the review process, only four provided randomised evidence. No negative studies with respect to efficacy were found. ECT is effective in the acute treatment of late life depression. ECT is generally safe, although a number of serious complications possibly related to ECT have been described. Most of the objectives of this review could not be answered or refuted with certainty, because firm randomised evidence on the efficacy and safety of ECT in the depressed elderly is missing. Conclusions ECT is effective in the acute treatment of late life depression and is generally safe. Important questions such as the relative efficacy of ECT over antidepressants, the long‐term efficacy of ECT, morbidity and mortality related to ECT, cost‐effectiveness and the efficacy of ECT in subgroups of patients cannot be answered and need to be studied further. Copyright © 2003 John Wiley & Sons, Ltd.