Multiple-monitored electroconvulsive therapy: safety and efficacy in elderly depressed patients

Area of Science:

• Neuroscience
• Psychiatry
• Gerontology

Background:

• Severe endogenous depression affects both elderly and non-elderly populations.
• Electroconvulsive therapy (ECT) is a recognized treatment for severe depression.
• Multiple-monitored electroconvulsive therapy (MMECT) offers a modified approach to ECT.

Purpose of the Study:

• To compare the safety and efficacy of MMECT in elderly versus non-elderly patients with severe endogenous depression.
• To evaluate therapeutic outcomes and adverse events associated with MMECT across different age groups.
• To assess the tolerability of MMECT, including the number of treatment sessions and seizure duration.

Main Methods:

• Retrospective chart review of 44 patients with severe endogenous depression treated with MMECT.
• Division of patients into two groups: elderly and non-elderly.
• Comparison of MMECT parameters including anesthesia inductions, total seizures, seizure time, and therapeutic outcomes between groups.

Main Results:

• MMECT demonstrated comparable safety and efficacy in both elderly and non-elderly patient groups.
• The elderly group tolerated multiple seizures as well as the non-elderly group.
• One case of myocardial infarction in an elderly patient and confusional states when MMECT was combined with lithium were noted.
• The overall number of anesthesia inductions was lower with MMECT compared to conventional ECT.

Conclusions:

• MMECT is a safe and efficacious treatment option for severe endogenous depression in the elderly, similar to its use in younger adults.
• Elderly patients can tolerate MMECT, including multiple seizures, effectively.
• MMECT may offer an advantage over conventional ECT due to a potentially lower number of required treatment sessions.