Journal Article

Speed of remission in elderly patients with depression: Electroconvulsive therapy v. medication

Spaans, Harm-Pieter, Verwijk, Esmée, Stek, Max L., Kok, Rob M., Bouckaert, Filip, Sienaert, Pascal, Kho, King H., van den Berg, Julia F.

2015

Overview

Severe depression can be a life-threatening disorder, especially in elderly patients. A fast-acting treatment is crucial for this group. Electroconvulsive therapy (ECT) may work faster than medication. To compare the speed of remission using ECT v. medication in elderly in-patients. The speed of remission in in-patients with a DSM-IV diagnosis of major depression (baseline MADRS score ≥20) was compared between 47 participants (mean age 74.0 years, s.d. = 7.4) from an ECT randomised controlled trial (RCT) and 81 participants (mean age 72.2 years, s.d. = 7.6) from a medication RCT (nortriptyline v. venlafaxine). Mean time to remission was 3.1 weeks (s.d. = 1.1) for the ECT group and 4.0 weeks (s.d. = 1.0) for the medication group; the adjusted hazard ratio for remission within 5 weeks (ECT v. medication) was 3.4 (95% CI 1.9-6.2). Considering the substantially higher speed of remission, ECT deserves a more prominent position in the treatment of elderly patients with severe depression.

• Publisher: Cambridge University Press
• Subject: Age / Aged / Antidepressants / Antidepressive Agents, Second-Generation - therapeutic use / Cyclohexanols - therapeutic use / Depressive Disorder, Major - drug therapy / Depressive Disorder, Major - therapy / Drugs / Electroconvulsive Therapy / Female / Geriatrics / Group therapy / Humans / Inpatient care / Life threatening / Male / Medical diagnosis / Medical treatment / Mental depression / Mental health services / Nortriptyline - therapeutic use / Older people / Patients / Psychiatry / Psychosis / Remission / Remission (Medicine) / Remission Induction / Therapy / Time Factors / Treatment Outcome / Venlafaxine / Venlafaxine Hydrochloride