Clinical outcome and adverse effects of electroconvulsive therapy in elderly psychiatric patients. J Geriatr Psychiatry Neurol

We evaluated the short-term outcome and side effects of electroconvulsive treatment (ECT) in a population of elderly psychiatric patients. The material included patients consecutively hospitalized at a psychogeriatric department within a period of 5 years. From a total number of 239 patients, we included 52 treated with ECT (22%). Altogether, 41 patients (79%) improved clinically. Of them, 21 (40%) of the patients went home after the treatment. Twenty patients (38%) developed adverse reactions from the ECT treatment. Impaired memory (14%), confusion (6%), and hypertension (6%) represented the most commonly reported negative reactions secondary to the treatment. The findings from the study support previous assumptions that ECT is effective in the treatment of serious psychiatric disorders in elderly patients. Because of the relative high frequency of side effects, the patients should be selected carefully. (J Geriatr Psychiatry Neurol 2002; 15:73-76). The exact prevalence of depression in the elderly is not known. Minor depression may occur in more than 10%, whereas major depression occurs less frequently accord-ing to community-based studies. 1,2 The number of reports evaluating the effect of electroconvulsive therapy (ECT) in older patients with a prospective study design is lim-ited. The clinical outcome after ECT in the elderly is favor-able according to some authors.3-5 Electroconvulsive therapy seems to be effective regardless of age and is prob-ably not inferior to pharmacologic treatment. 3,6 Also, the frequency of adverse effects may be independent of age.4 Memory decline and gastrointestinal, pulmonary, and cardiac events are some of the reported negative effects of the treatment.7,8 Because ECT in some centers is used only in cases resistant to medical treatment, one might expect that the true outcome of the treatment could be underestimated.9 Because of limited knowl-edge in this field, the problem of selecting those patient