Multiple-monitored Electroconvulsive Therapy: Safety and Efficacy in Elderly Depressed Patients
Forty-four patients with severe endogenous depression, all of whom had been administered multiple-monitored electroconvulsive therapy (MMECT), were studied by retrospective chart review. The subjects were divided into two groups, the elderly and the nonelderly, and compared for number of anesthesia inductions (treatment sessions), total number of seizures, total seizure time, and therapeutic outcome. One myocardial infarction occurred in an elderly man, and a confusional state developed whenever MMECT was administered simultaneously with lithium. The conclusions from this project are that MMECT is as safe and efficacious for the elderly as for the nonelderly and that the elderly tolerate many seizures as well as do the nonelderly. While other variables were similar between groups, the overall number of anesthesia inductions in both groups was less than is expected with conventional electroconvulsive therapy.
Available from: Augustus John Rush
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ABSTRACT: The efficacy of depression-targeted, time-limited psychotherapies as acute phase treatments for mild-to-moderately depressed outpatients with MDD is clear. It is often equal to medication, and may be preferred in milder, uncomplicated, nonchronic cases. Problem-solving therapy (PST) or Bibliotherapy (BBT) also appear efficacious in this population. Maintenance treatments appear beneficial but are exceeded by medication. However, converting medication responders into remitters with psychotherapy seems an effective approach.
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