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Bifrontal electroconvulsive therapy in the elderly: a 2-year retrospective
John D Little1, Martin R Atkins, Jo Munday
1Grampians Psychiatric Service, Victoria, Australia. LesleyH@bhs.org.au
The Journal of ECT
|September 3, 2004
Summary
Bifrontal electroconvulsive therapy (ECT) effectively treated depression in older adults, with most patients showing significant improvement and few relapses. Cognitive side effects were noted in some individuals.
Area of Science:
- Geriatric Psychiatry
- Neuroscience
- Clinical Psychology
Background:
- Depression is a significant health concern in elderly populations.
- Electroconvulsive therapy (ECT) is a recognized treatment for severe depression.
- Bifrontal (BF) ECT is a specific modality of ECT with potential benefits.
Purpose of the Study:
- To evaluate the clinical effectiveness of bifrontal (BF) electroconvulsive therapy (ECT) in patients aged 65 and older with depressive disorders.
- To assess treatment response, relapse rates, and cognitive side effects associated with BF ECT in this demographic.
Main Methods:
- Retrospective chart review of patients aged 65+ who underwent BF ECT for depression between 2000 and 2002.
- Analysis of patient demographics, depression type (unipolar/bipolar), treatment outcomes, and side effects.
Main Results:
- 86% of 14 elderly patients (mean age 73.9) responded unequivocally to BF ECT after an average of 8.5 treatments.
- Cognitive side effects were reported in 35% of patients.
- High rates of sustained remission were observed, with only 1 relapse during a mean follow-up of 18.7 months.
Conclusions:
- Bifrontal ECT demonstrates significant clinical efficacy in treating elderly patients with unipolar or bipolar depression.
- While generally well-tolerated, cognitive side effects are a consideration.
- BF ECT offers a viable and effective treatment option for geriatric depression, associated with sustained remission.