ELECTROCONVULSIVE-THERAPY IN THE ELDERLY - A RETROSPECTIVE STUDY IN 27 PATIENTS

Twenty-seven patients above 70 years of age who were given electroconv ulsive therapy for a variety of disorders were included in this retros pective study. Diagnoses were established using DSM-III R criteria. Te chnique, patient selection, outcomes, and complications were analyzed and compared with previously published data. Special attention was giv en to pseudodementia. In the short-term, complete remission, improveme nt, and treatment failure were recorded in 44.5 %, 44.5 %, and 11 % of patients, respectively. Complete remission rates were 66 % in patient s with severe major depression with or without psychotic features and 78 % in patients with major depression and psychotic features. Complet e remission rates tended to increase with advancing age, although this trend was not significant. Untoward effects occurred in nearly 55 % o f cases. Most were mild and transient. Side effects requiring disconti nuation of electroconvulsive therapy were seen in only 11 % of patient s. Evaluation of medium-term results was difficult because a large num ber of patients were lost to follow-up. However, 40 % of patients deve loped relapses or recurrences, suggesting a need for maintenance treat ment. These data suggest that electroconvulsive therapy is safe and ef fective in elderly patients, especially for the treatment of severe ma jor depression or psychotic disorders in which electroconvulsive thera py rather than pharmacotherapy may be the best first-line treatment.