Elektroconvulsietherapie effectief en veilig bij 55 patiënten van 56 jaar en ouder met stemmingsstoornissen en somatische comorbiditeit

To determine the efficacy and safety of electroconvulsive therapy (ECT) in patients aged 56 years and older with mood disorders who had failed to respond to pharmacotherapy.

Design

Retrospective, descriptive.

Method

Demographic data, illness and treatment characteristics were registered for all patients (age ≥ 56 years) treated with ECT in the period 1 January 1998 to 31 December 2000. The efficacy of ECT was evaluated with the ‘Montgomery-Åsberg depression rating scale’ (MADRS) and cognitive side effects were evaluated with the ‘Mini-mental state examination’ (MMSE). Descriptive statistical methods were used for the analysis.

Results

A total of 58 treatments were evaluated in 55 patients with a mean age of 73 years. Most patients had a recurrent depressive disorder with physical comorbidity that did not respond to pharmacotherapy. An average of 12 ECT sessions were given per treatment. In patients where a MADRS score was known before and after ECT, 74 exhibited a significant improvement and 48 reached a complete remission of the depression. Cognitive side effects occurred in 28 of the patients. No serious physical complications were reported.

Conclusion

ECT is an essential means of intervention in treating mood disorders of the elderly and should be considered in an earlier phase, especially in patients with physical comorbidity.