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Electroconvulsive Therapy for Bipolar Depression in Older Adults
Nicholas Morcos1, Susan Maixner, Daniel F Maixner
1From the Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI.
The Journal of ECT
|March 4, 2021
Summary
Electroconvulsive therapy (ECT) is safe and effective for older adults with bipolar depression. This treatment showed significant symptom improvement and cognitive benefits, challenging concerns about side effects in this population.
Area of Science:
- Geriatric Psychiatry
- Neuroscience
- Clinical Therapeutics
Background:
- Electroconvulsive therapy (ECT) is established for mood disorders in younger adults and effective for unipolar depression in older adults.
- Limited data exist on ECT efficacy and safety for bipolar depression in geriatric populations.
Purpose of the Study:
- To evaluate the outcomes of electroconvulsive therapy (ECT) in older adults diagnosed with bipolar depression.
- To assess the safety and effectiveness of ECT in this specific patient demographic.
Main Methods:
- Retrospective study of patients aged 65 years and older treated with ECT for bipolar depression over a 7-year period.
- Inclusion based on chart review and documented outcome measures.
- Primary outcomes included changes in Montreal Cognitive Assessment (MoCA) and Clinical Global Impressions (CGI) scores.
Main Results:
- 34 patients met inclusion criteria, showing statistically significant improvements in MoCA scores and reductions in CGI severity scores post-ECT.
- A subset of 20 patients demonstrated significant reduction in Montgomery-Asberg Depression Rating Scale (MADRS) scores.
- No serious adverse effects were reported, and no patients discontinued treatment.
Conclusions:
- Electroconvulsive therapy (ECT) is well-tolerated and effective for treating bipolar depression in older adults.
- Findings suggest ECT can be a regular consideration for managing treatment-resistant bipolar depression in the elderly.
- Results challenge concerns regarding cognitive decline associated with ECT in older populations.
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