Electroconvulsive therapy: a life course approach for recurrent depressive disorder

Area of Science:

• Neuroscience
• Psychiatry
• Geriatric Medicine

Background:

• Recurrent depressive disorder poses significant long-term challenges.
• Electroconvulsive therapy (ECT) is a treatment option for severe depression.
• There is ongoing debate regarding the optimal frequency and long-term use of ECT.

Observation:

• A case of an 89-year-old woman with a 60-year history of recurrent depression treated with approximately 400 electroconvulsive therapy (ECT) sessions.
• The patient experienced minimal cognitive impairment despite extensive ECT exposure.
• The patient maintained an excellent safety record with ECT, even while frail with comorbidities.

Findings:

• Extensive ECT exposure did not result in significant cognitive impairment in this patient.
• Electroconvulsive therapy (ECT) proved effective for both acute episodes and maintenance therapy in a long-term recurrent depression case.
• The case suggests maintenance ECT may be an underused therapeutic option for recurrent depression.

Implications:

• This case supports the potential benefit of maintenance electroconvulsive therapy (ECT) for select patients with recurrent depression.
• Individualized treatment plans should consider the long-term efficacy and safety of ECT.
• Incorporating the views of caregivers is crucial for optimizing treatment approaches in recurrent depression.