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

doi:https://doi.org/10.1192/bjp.bp.114.148213

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

Psychiatry (VUmc)

Research output: Contribution to journal › Article › Academic › peer-review

75 Citations (Scopus)

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.

Original language	English
Pages (from-to)	67-71
Number of pages	5
Journal	British journal of psychiatry
Volume	206
Issue number	1
DOIs	https://doi.org/10.1192/bjp.bp.114.148213
Publication status	Published - Jan 2015

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title = "Speed of remission in elderly patients with depression: Electroconvulsive therapy V. medication",

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.",

author = "Spaans, {Harm Pieter} and Pascal Sienaert and Filip Bouckaert and {Van Den Berg}, {Julia F.} and Esm{\'e}e Verwijk and Kho, {King H.} and Stek, {Max L.} and Kok, {Rob M.}",

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doi = "https://doi.org/10.1192/bjp.bp.114.148213",

language = "English",

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T1 - Speed of remission in elderly patients with depression

T2 - Electroconvulsive therapy V. medication

AU - Spaans, Harm Pieter

AU - Sienaert, Pascal

AU - Bouckaert, Filip

AU - Van Den Berg, Julia F.

AU - Verwijk, Esmée

AU - Kho, King H.

AU - Stek, Max L.

AU - Kok, Rob M.

PY - 2015/1

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N2 - 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.

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

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