scholarly journals Is ECT a viable option to treat depression in older adults with bipolar disorder who are vulnerable to cognitive side effects?

2020 ◽  
Author(s):  
Machteld A. J. T. Blanken ◽  
Mardien L. Oudega ◽  
Sigfried N. T. M. Schouws ◽  
Jeroen S. Zanten ◽  
Jennifer R. Gatchel ◽  
...  
2020 ◽  
Vol 32 (9) ◽  
pp. 1165-1177 ◽  
Author(s):  
Duy Do ◽  
Jason Schnittker

Objectives: Many medications have cognitive impairment, memory loss, amnesia, or dementia as side effects (“cognitive side effects” hereafter), but little is known about trends in the prevalence of these medications or their implications for population-level cognitive impairment. Method: We use data from the National Health and Nutrition Examination Survey (1999–2016) to describe trends in the use of medications with cognitive side effects among adults aged 60+ ( N = 16,937) and their implications for cognitive functioning (measured using word learning and recall, animal fluency, and digit symbol substitution assessments). Results: Between 1999 to 2000 and 2015 to 2016, the prevalence of older adults taking one, two, and at least three medications with cognitive side effects increased by 10.2%, 57.3%, and 298.7%, respectively. Compared to non-users, respondents who simultaneously used three or more medications with cognitive side effects scored 0.22 to 0.27 standard deviations lower in word learning and recall ( p = .02), digit symbol substitution ( p < .01), and the average standardized score of the three assessments ( p < .001). Limitation: Dosage of medications associated with cognitive side effects was not measured. Discussion: Concurrent use of medications with cognitive side effects among older adults has increased dramatically over the past two decades. The use of such medications is associated with cognitive impairment and may explain for disparities in cognitive function across subgroups. These findings highlight the need for cognitive screenings among patients who consume medications with cognitive side effects. They also highlight the synergic effects of polypharmacy and potential drug-drug interactions that result in cognitive deficits.


2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Eric Cretaz ◽  
André R. Brunoni ◽  
Beny Lafer

Objective. Magnetic seizure therapy (MST) is a novel, experimental therapeutic intervention, which combines therapeutic aspects of electroconvulsive therapy (ECT) and transcranial magnetic stimulation, in order to achieve the efficacy of the former with the safety of the latter. MST might prove to be a valuable tool in the treatment of mood disorders, such as major depressive disorder (MDD) and bipolar disorder. Our aim is to review current literature on MST.Methods. OVID and MEDLINE databases were used to systematically search for clinical studies on MST. The terms “magnetic seizure therapy,” “depression,” and “bipolar” were employed.Results. Out of 74 studies, 8 met eligibility criteria. There was considerable variability in the methods employed and samples sizes were small, limiting the generalization of the results. All studies focused on depressive episodes, but few included patients with bipolar disorder. The studies found reported significant antidepressant effects, with remission rates ranging from 30% to 40%. No significant cognitive side effects related to MST were found, with a better cognitive profile when compared to ECT. Conclusion. MST was effective in reducing depressive symptoms in mood disorders, with generally less side effects than ECT. No study focused on comparing MST to ECT on bipolar depression specifically.


1999 ◽  
Vol 14 (3) ◽  
pp. 167-172 ◽  
Author(s):  
A. Honig ◽  
B. M.G. Arts ◽  
R. W.H.M. Ponds ◽  
W. J. Riedel

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Melis Orhan ◽  
Nicole Korten ◽  
Ralph Kupka ◽  
Patricia van Oppen ◽  
Max Stek ◽  
...  

Abstract Background Many frequently used instruments fail to assess psychosocial functioning in patients with bipolar disorder. The Functioning Assessment Short Test (FAST) was developed in order to tackle this problem and to assess the main functioning problems experienced by patients with bipolar disorder. However, the original FAST is not fully applicable in older adults due to the domain of occupational functioning. The aim of our study was to validate an adapted version for Older adults (FAST-O) in a group of older adults with bipolar disorder (OABD). Methods 88 patients aged 50 years and over diagnosed with bipolar disorder were included. We adapted the items in the area of “work-related functioning” of the FAST into items assessing “societal functioning”. Several measurements were conducted in order to analyse the psychometric qualities of the FAST-O (confirmatory factor analysis for internal structure, Cronbach’s alpha for internal consistency, Spearman’s rho for concurrent validity, Mann–Whitney U test for discriminant validity). Results Mean age in the study sample was 65.3 (SD = 7.5) and 57.3% was female. The internal structure was most similar to the internal structure of the original FAST. The internal consistency was excellent (Cronbach’s alpha = .93). The concurrent validity when correlated with the Social and Occupational Functioning Assessment Scale was low, but significant. The FAST-O was also able to distinguish between euthymic and symptomatic OABD patients. Conclusions The FAST-O has strong psychometric qualities. Based on our results, we can conclude that the FAST-O is a short, efficient solution in order to replace global rating scales or extensive test batteries in order to assess daily functioning of older psychiatric patients in a valid and reliable manner.


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