Electroconvulsive Therapy May Be Effective Treatment for Major Depression

Five patients with trisomy 21 (Down's syndrome (DS)), referred to us for evaluation of dementia, were instead found to have major depression. All had shown cognitive and behavioural deterioration and this had led to a mistaken diagnosis of Alzheimer's disease in two. We outline and contrast the features of major depression and Alzheimer's disease in DS, and suggest that electroconvulsive therapy is an effective treatment for major depression in DS.

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ECT: Physiology, Indications, and Treatment

10.2310/psych.13068 ◽

2019 ◽

Author(s):

Max Fink

Keyword(s):

Bipolar Disorder ◽

Major Depression ◽

Effective Treatment ◽

Electroconvulsive Therapy ◽

Suicide Risk ◽

Dementia Praecox ◽

Brain Wave ◽

Grand Mal ◽

Key Words Anesthesia ◽

Pituitary Glands

Inducing grand mal seizures (electroshock, electroconvulsive therapy) developed as an effective treatment to alleviate the psychosis of dementia praecox. Clinicians quickly recognized that seizures also relieved depressed moods, suicide risk, catatonia, manic excitement, and delirium. It is an unheralded, often stigmatized, medical achievement. Seizures may be induced chemically or with electric or magnetic currents. Grand mal seizures must be repeated for persistent benefits. Not all seizures are equally effective. Effective seizures are marked by bilateral electroencephalographic brain wave changes and neuroendocrine discharges from hypothalamic-pituitary glands. Treatments are remarkably safe, with zero mortality. Immediate effects on memory are common but are almost always transient. They are not a practical deterrent to the treatments, although they are widely cited to reject its use. The stigmatization of induced seizures that places it as a “last resort” therapy is wasteful and unethical. It offers a remarkable opportunity for advancement in neuroscience. This review contains 4 figures, 3 tables, and 90 references. Key words: anesthesia, bipolar disorder, catatonia, delirium, electroconvulsive therapy, electroencephalography, major depression, melancholia, neuroendocrine, seizures

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Cognitive Function Before and After Electroconvulsive Therapy in Patients with Major Depression

10.26226/morressier.5885d719d462b8028d89293a ◽

2017 ◽

Author(s):

Sabrina Mörkl

Keyword(s):

Cognitive Function ◽

Major Depression ◽

Electroconvulsive Therapy ◽

Before And After

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Atropine versus Hyoscine Premedication for Electroconvulsive Therapy in Major Depression

10.26226/morressier.5a6ef3f0ab9a5f002a4c8bb6 ◽

2018 ◽

Author(s):

Mahshid Ghasemi

Keyword(s):

Major Depression ◽

Electroconvulsive Therapy

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Efficacy, safety and tolerability of formula-based unilateral vs bilateral electroconvulsive therapy in the treatment of major depression: A randomized open label controlled trial

Journal of Psychiatric Research ◽

10.1016/j.jpsychires.2020.12.002 ◽

2021 ◽

Vol 133 ◽

pp. 52-59

Author(s):

Monika Dominiak ◽

Anna Z. Antosik-Wójcińska ◽

Zuzanna Goetz ◽

Olga Sikorska ◽

Bogdan Stefanowski ◽

...

Keyword(s):

Major Depression ◽

Electroconvulsive Therapy ◽

Controlled Trial ◽

Open Label

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Electroconvulsive Therapy and Age: Effectiveness, Safety and Tolerability in the Treatment of Major Depression among Patients under and over 65 Years of Age

Pharmaceuticals ◽

10.3390/ph14060582 ◽

2021 ◽

Vol 14 (6) ◽

pp. 582

Author(s):

Monika Dominiak ◽

Anna Z. Antosik-Wójcińska ◽

Marcin Wojnar ◽

Paweł Mierzejewski

Keyword(s):

Major Depression ◽

Autobiographical Memory ◽

Electroconvulsive Therapy ◽

Cognitive Functions ◽

Rating Scale ◽

Short Form ◽

Serious Adverse Events ◽

Before And After ◽

Trail Making ◽

Resistant Depression

Electroconvulsive therapy (ECT) remains the most effective therapy in treatment-resistant depression. However, the safety of ECT has been consistently questioned, particularly among elderly patients. We assessed the efficacy and safety of ECT in patients before and after 65 years old. The study was conducted between 2015 and 2018 and included 91 patients (61 under and 29 over 65 years old) with major depression undergoing ECT. The Hamilton Depression Rating Scale was used to evaluate efficacy. Cognitive functions were assessed using: MMSE, RAVLT, Trail Making Test, Stroop Test and Autobiographical Memory Interview-Short Form. ECT was more effective in older patients as compared to younger (p < 0.001). No serious adverse events were observed in either group. Increased blood pressure and arrhythmias were more common in the older compared to the younger group (p = 0.044 and p = 0.047, respectively), while disturbances of consciousness did not differ between groups (p = 0.820). Most of the cognitive functions remained unchanged compared to baseline, whereas the outcomes of MMSE, RAVLT and Stroop tests showed greater improvements in the older compared to the younger group (all p < 0.05). The decline in the retrieval consistency of autobiographical memory was more pronounced in the younger group (p = 0.024). ECT is a highly effective, safe and well-tolerated method of treating depression regardless of age.

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332 - Electroconvulsive therapy in older adults with major depression was not associated with cognitive decline during a 15-year follow-up

International Psychogeriatrics ◽

10.1017/s104161022000232x ◽

2020 ◽

Vol 32 (S1) ◽

pp. 91-91

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Major Depression ◽

Cognitive Decline ◽

Electroconvulsive Therapy ◽

Antidepressant Treatment ◽

Community Sample ◽

Control Group

AUTHORS:Kerstin Johansson, Karolina Thömkvist, Ingmar Skoog and Sacuiu SF* (*presenter)OBJECTIVE:To determine the effects of electroconvulsive therapy (ECT) in major depression in relation to the development of dementia during long-term follow-up.METHOD:In an observational clinical prospective study of consecutive patients 70 years and older diagnosed with major depression at baseline 2000-2004 (n=1090), who were free of dementia and received antidepressant treatment, with or without ECT, we sought to determine if cognitive decline (mild cognitive impairment and dementia) during 15 -year follow-up was associated with receiving ECT at baseline. The control group was selected among the participants in the Gothenburg H70 Birth Cohort Studies matched by age group and sex 1:1.RESULTS:Among patients with affective syndromes 7% received ECT. During follow-up, 157 patients were diagnosed with dementia, equal proportions among those who received ECT (14.5%) and those who did not receive ECT (14.5%). The relation between ECT and cognitive decline remained non-significant irrespective antidepressive medication or presence of mild cognitive impairment at baseline.CONCLUSION:Preliminary results indicate that ECT was not associated with the development of cognitive decline in the long-term in a hospital-based cohort of 70+ year-olds. The results remain to verify against controls from a representative community sample.

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