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

Harm Pieter Spaans, Pascal Sienaert, Filip Bouckaert, Julia F. Van Den Berg, Esmée Verwijk, King H. Kho, Max L. Stek, Rob M. Kok

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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.

Original languageEnglish
Pages (from-to)67-71
Number of pages5
JournalBritish journal of psychiatry
Issue number1
Publication statusPublished - Jan 2015

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