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Speed of remission in elderly patients with depression: Electroconvulsive therapy v. medication

  • Harm-Pieter Spaans (a1), Pascal Sienaert (a2), Filip Bouckaert (a2), Julia F. van den Berg (a1), Esmée Verwijk (a1), King H. Kho (a1), Max L. Stek (a3) and Rob M. Kok (a1)...

Abstract

Background

Severe depression can be a life-threatening disorder, especially in elderly patients. A fast-acting treatment is crucial for this group. Electroconvulsive therapy (ECT) may work faster than medication.

Aims

To compare the speed of remission using ECT v. medication in elderly in-patients.

Method

The speed of remission in in-patients with a DSM-IV diagnosis of major depression (baseline MADRS score $20) was compared between 47 participants (mean age 74.0 years, s.d. = 7.4) from an ECT randomised controlled trial (RCT) and 81 participants (mean age 72.2 years, s.d. = 7.6) from a medication RCT (nortriptyline v. venlafaxine).

Results

Mean time to remission was 3.1 weeks (s.d. = 1.1) for the ECT group and 4.0 weeks (s.d. = 1.0) for the medication group; the adjusted hazard ratio for remission within 5 weeks (ECT v. medication) was 3.4 (95% CI 1.9–6.2).

Conclusions

Considering the substantially higher speed of remission, ECT deserves a more prominent position in the treatment of elderly patients with severe depression.

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Copyright

Corresponding author

Harm-Pieter Spaans, MD, Parnassia Psychiatric Institute, Clinical Centre for the Elderly, Mangostraat 1, 2552 KS The Hague, The Netherlands. Email: hp.spaans@parnassia.nl

Footnotes

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Declaration of interest

None.

Footnotes

References

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Speed of remission in elderly patients with depression: Electroconvulsive therapy v. medication

  • Harm-Pieter Spaans (a1), Pascal Sienaert (a2), Filip Bouckaert (a2), Julia F. van den Berg (a1), Esmée Verwijk (a1), King H. Kho (a1), Max L. Stek (a3) and Rob M. Kok (a1)...

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