'Side effects' of ECT are mainly depressive phenomena and are independent of age

Background: The aetiology of reported side effects of electroconvulsive the rapy (ECT) is unclear. We examined the interaction of depression and age on adverse neuropsychological and putative side effects of ECT. Method: Inpat ients (N = 81 ; median age 70 years) with major depression were assessed pr ospectively pre-ECT, immediately post-ECT and 1-3 years later. Patients wer e administered the Hamilton Rating Scale for Depression (HRSD), the Global Assessment of Functioning scale (GAF) and neuropsychological tests from the Wechsler Memory Scale. Side effects and total burden scores were rated pre - and post-treatment. Results: HRSD and GAF scores improved with treatment after ECT. but the prevalence and total burden of side effects were unchang ed. Side effect burden was related to depression level before and after ECT . Improvement in depression correlated with reduction in side effect burden . There was a significant decline in side effect burden after controlling f or change in depression. Patients' scores on neuropsychological measures di d not appear to change after ECT or between pre-ECT and follow-up. Re-analy sis, allowing for age. chronicity of depression, medication use and develop ment of dementia. did not alter the findings. Limitations: lack of a contro l group, lack of information on ECT technique, incomplete data sets and lim ited neuropsychological testing. Conclusions: ECT, an effective treatment f or depression, does not cause significant side effects or neuropsychologica l impairment. which are more likely to be depressive phenomena. ECT appears to be safe for old (65 years) and very old (greater than or equal to 75 ye ars) patients, who do not appear to be more susceptible to adverse effects. (C) 2001 Elsevier Science B.V. All rights reserved.