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Unilateral and bilateral ECT in elderly patients. A comparative study

R M Fraser, I B Glass

    Acta Psychiatrica Scandinavica
    |July 1, 1980
    PubMed
    Summary

    Unilateral electroconvulsive therapy (ECT) is effective for elderly depression, with faster recovery than bilateral ECT. Memory functions normalized post-treatment in both groups, with unilateral showing fewer side effects.

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    Area of Science:

    • Geriatric Psychiatry
    • Neuroscience
    • Clinical Psychology

    Background:

    • Electroconvulsive therapy (ECT) is a treatment for severe depression.
    • Elderly patients with depression present unique challenges in treatment response and recovery.
    • Comparing unilateral and bilateral ECT is crucial for optimizing patient outcomes.

    Purpose of the Study:

    • To compare the efficacy and side effects of unilateral versus bilateral ECT in elderly depressed patients.
    • To assess the impact of ECT on memory functions and post-ictal recovery times.
    • To identify predictors of treatment outcome in this population.

    Main Methods:

    • Randomized controlled trial involving 29 elderly depressed patients.
    • Patients were assigned to unilateral or bilateral ECT.
    • Outcomes measured included clinical improvement, memory changes, and post-ictal recovery by blind observers.

    Main Results:

    • No significant difference in clinical improvement or treatment duration between unilateral and bilateral ECT.
    • Post-ictal recovery times were significantly longer with bilateral ECT.
    • Memory functions uniformly improved during and after treatment, returning to normal levels.
    • Predictors of good outcome included pathological guilt and severity; longer illness duration predicted poor outcome.

    Conclusions:

    • Unilateral ECT is a safe and effective treatment for selected elderly depressed patients.
    • Bilateral ECT offers no advantages and results in longer recovery times.
    • Further research into ECT's impact on cognitive function and long-term outcomes is warranted.

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