The role of electroconvulsive and neuromodulation therapies in the treatment of geriatric depression

Psychiatr Clin North Am. 2013 Dec;36(4):607-30. doi: 10.1016/j.psc.2013.08.007. Epub 2013 Oct 6.

Abstract

Geriatric depression is associated with increased mortality because of suicide and decreases in functional and physical health. Many elders' depression is resistant to psychotherapy and medication and can become chronic. Electroconvulsive therapy (ECT) is increasingly used in the treatment of medication-resistant or life-threatening geriatric depression. Neuromodulation therapies (subconvulsive, focal, or subconvulsive and focal) are alternatives for the management of treatment-resistant depression in the elderly. Therapies that combine both strategies could be safer but may not be as effective as ECT. This review covers the evidence on the safety and efficacy of ECT and the neuromodulation therapies in geriatric depression.

Keywords: Electroconvulsive therapy; Geriatric depression; Neuromodulation; Treatment-resistant depression.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Aged
  • Anesthesia / methods
  • Comorbidity
  • Dementia / epidemiology
  • Dementia / therapy
  • Depressive Disorder / epidemiology
  • Depressive Disorder / therapy*
  • Depressive Disorder, Treatment-Resistant / epidemiology
  • Depressive Disorder, Treatment-Resistant / therapy
  • Electric Stimulation Therapy / methods*
  • Electric Stimulation Therapy / trends
  • Electroconvulsive Therapy / adverse effects
  • Electroconvulsive Therapy / methods*
  • Electroconvulsive Therapy / trends
  • Evidence-Based Practice / methods*
  • Humans
  • Informed Consent*
  • Parkinson Disease / epidemiology
  • Parkinson Disease / therapy
  • Stroke / epidemiology
  • Transcranial Magnetic Stimulation / methods
  • Treatment Outcome