Electroconvulsive therapy effective and safe in 55 patients aged 56 years and older with mood disorders and physical comorbidity

OBJECTIVE: 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 > or = 56 years) treated with ECT in the period 1 January 1998 to 31 December 2000. The efficacy of ECT was evaluated with the 'Montgomery-Asberg 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.