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Published on: August 15, 2017
Electroconvulsive therapy in individuals with dementia/major NCD presenting with behavioral symptoms: a systematic
Anil K Bachu1, Vijaya Padma Kotapati2, Tejasvi Kainth3
1Department of Psychiatry, Baptist Health - UAMS Psychiatry Residency Education Program, North Little Rock, AR, USA; Allegheny Clinic, Psychiatry and Behavior Health Institute, Pittsburgh, PA, USA.
Objective:
This study aims to systematically review the literature on using electroconvulsive therapy (ECT) in patients with dementia/major NCD (Neuro cognitive disorder) presenting with behavioral symptoms.
Design:
We conducted a PRISMA-guided systematic review of the literature. We searched five major databases, including PubMed, Medline, Embase, Cochrane, and registry (ClinicalTrials.gov), collaborating with "ECT" and "dementia/major NCD" as our search terms.
Measurements:
Out of 445 published papers and four clinical trials, only 43 papers and three clinical trials met the criteria. There were 22 case reports, 14 case series, 4 retrospective chart reviews, 1 retrospective case-control study, 1 randomized controlled trial, and 2 ongoing trials. We evaluated existing evidence for using ECT in dementia/major NCD patients with depressive symptoms, agitation and aggression, psychotic symptoms, catatonia, Lewy body dementia/major NCD, manic symptoms, and a combination of these symptoms.
Settings:
The studies were conducted in the in-patient setting.
Participants:
Seven hundred and ninety total patients over the age of 60 years were added.
Results:
All reviewed studies reported symptomatic benefits in treating behavioral symptoms in individuals with dementia/major NCD. While transient confusion, short-term memory loss, and cognitive impairment were common side effects, most studies found no serious side effects from ECT use.
Conclusion:
Current evidence from a systematic review of 46 studies indicates that ECT benefits specific individuals with dementia/major NCD and behavioral symptoms, but sometimes adverse events may limit its use in these vulnerable individuals.
