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Electroconvulsive therapy for post-stroke depressed geriatric patients
M B Currier1, G B Murray, C C Welch
1Psychiatric Consultation Service, Massachusetts General Hospital, Boston.
The Journal of Neuropsychiatry and Clinical Neurosciences
|January 1, 1992
Summary
Electroconvulsive therapy (ECT) effectively treats post-stroke depression in medically ill older adults. However, relapses and complications like confusion can occur, necessitating careful monitoring.
Area of Science:
- Geriatric Medicine
- Neurology
- Psychiatry
Background:
- Post-stroke depression is a common and debilitating condition in geriatric patients.
- Electroconvulsive therapy (ECT) is a treatment option for severe depression, but its efficacy and safety in medically ill elderly stroke survivors are not well-established.
Purpose of the Study:
- To evaluate the effectiveness and safety of electroconvulsive therapy (ECT) for geriatric patients with post-stroke depression.
- To assess the rate of relapse and occurrence of medical complications associated with ECT in this population.
Main Methods:
- Retrospective review of medical records for 20 medically ill geriatric patients treated with ECT for post-stroke depression between 1982 and 1991.
- Analysis of patient outcomes, including depression improvement, relapse rates, and ECT-related medical complications.
Main Results:
- 95% of patients showed improvement with ECT.
- 37% experienced relapses, typically around 4 months post-ECT, despite maintenance antidepressants.
- 23% had ECT-related medical complications, and 15% experienced transient confusion or amnesia.
Conclusions:
- Electroconvulsive therapy (ECT) is a generally well-tolerated and effective treatment for medically ill geriatric patients suffering from post-stroke depression.
- While effective, the potential for relapse and transient cognitive side effects warrants consideration in treatment planning and patient monitoring.