Effects of continuation electroconvulsive therapy on quality of life in elderly depressed patients: A randomized clinical trial.

Published

Journal Article

We examined whether electroconvulsive therapy (ECT) plus medications ("STABLE + PHARM" group) had superior HRQOL compared with medications alone ("PHARM" group) as continuation strategy after successful acute right unilateral ECT for major depressive disorder (MDD). We hypothesized that scores from the Medical Outcomes Study Short Form-36 (SF-36) would be higher during continuation treatment in the "STABLE + PHARM" group versus the "PHARM" group. The overall study design was called "Prolonging Remission in Depressed Elderly" (PRIDE). Remitters to the acute course of ECT were re-consented to enter a 6 month RCT of "STABLE + PHARM" versus "PHARM". Measures of depressive symptoms and cognitive function were completed by blind raters; SF-36 measurements were patient self-report every 4 weeks. Participants were 120 patients >60 years old. Patients with dementia, schizophrenia, bipolar disorder, or substance abuse were excluded. The "PHARM" group received venlafaxine and lithium. The "STABLE + PHARM" received the same medications, plus 4 weekly outpatient ECT sessions, with additional ECT session as needed. Participants were mostly female (61.7%) with a mean age of 70.5 ± 7.2 years. "STABLE + PHARM" patients received 4.5 ± 2.5 ECT sessions during Phase 2. "STABLE + PHARM" group had 7 point advantage (3.5-10.4, 95% CI) for Physical Component Score of SF-36 (P < 0.0001), and 8.2 point advantage (4.2-12.2, 95% CI) for Mental Component Score (P < 0.0001). Additional ECT resulted in overall net health benefit. Consideration should be given to administration of additional ECT to prevent relapse during the continuation phase of treatment of MDD. CLINICAL TRIALS.GOV: NCT01028508.

Full Text

Duke Authors

Cited Authors

  • McCall, WV; Lisanby, SH; Rosenquist, PB; Dooley, M; Husain, MM; Knapp, RG; Petrides, G; Rudorfer, MV; Young, RC; McClintock, SM; Mueller, M; Prudic, J; Greenberg, RM; Weiner, RD; Bailine, SH; Youssef, NA; McCloud, L; Kellner, CH; CORE/PRIDE Work Group,

Published Date

  • February 2018

Published In

Volume / Issue

  • 97 /

Start / End Page

  • 65 - 69

PubMed ID

  • 29195125

Pubmed Central ID

  • 29195125

Electronic International Standard Serial Number (EISSN)

  • 1879-1379

Digital Object Identifier (DOI)

  • 10.1016/j.jpsychires.2017.11.001

Language

  • eng

Conference Location

  • England