Depression in the elderly and its management with electroconvulsive therapy

OBJECTIVE The aim of the study was to evaluate the effectiveness and safety of electroconvulsive therapy (ECT) in the management of depression in the elderly, and the compliance of the patients in its application. METHOD The sample consisted of 24 female inpatients aged over 65 years suffering from unipolar affective disorder. Modified unilateral and bilateral ECT and a combination of the two methods were used. RESULTS Of the 24 patients, treatment response was considered excellent in 19 (79%), moderate in three (12%) and minimal in two (9%). Excellent response was observed in patients with major depression with psychotic features. Unilateral application was found as effective as bilateral application. Mild transient cognitive disturbance was observed in seven patients (29%) and severe in three (12%). CONCLUSIONS ECT in elderly depressed patients can be considered as an effective and safe therapeutic method, especially when depression is accompanied with psychotic features, and in the case of non-tolerance by the patients of the side effects of antidepressant drugs and in patients with a history of suicide attempt with drugs.