Longitudinal Neurocognitive Effects of Combined Electroconvulsive Therapy (ECT) and Pharmacotherapy in Major Depressive Disorder in Older Adults: Phase 2 of the PRIDE Study.

Journal Article (Journal Article)

OBJECTIVE: There is limited information regarding neurocognitive outcomes of right unilateral ultrabrief pulse width electroconvulsive therapy (RUL-UB ECT) combined with pharmacotherapy in older adults with major depressive disorder. We report longitudinal neurocognitive outcomes from Phase 2 of the Prolonging Remission in Depressed Elderly (PRIDE) study. METHOD: After achieving remission with RUL-UB ECT and venlafaxine, older adults (≥60 years old) were randomized to receive symptom-titrated, algorithm-based longitudinal ECT (STABLE) plus pharmacotherapy (venlafaxine and lithium) or pharmacotherapy-only. A comprehensive neuropsychological battery was administered at baseline and throughout the 6-month treatment period. Statistical significance was defined as a p-value of less than 0.05 (two-sided test). RESULTS: With the exception of processing speed, there was statistically significant improvement across most neurocognitive measures from baseline to 6-month follow-up. There were no significant differences between the two treatment groups at 6 months on measures of psychomotor processing speed, autobiographical memory consistency, short-term and long-term verbal memory, phonemic fluency, inhibition, and complex visual scanning and cognitive flexibility. CONCLUSION: To our knowledge, this is the first report of neurocognitive outcomes over a 6-month period of an acute course of RUL-UB ECT followed by one of 2 strategies to prolong remission in older adults with major depression. Neurocognitive outcome did not differ between STABLE plus pharmacotherapy versus pharmacotherapy alone over the 6-month continuation treatment phase. These findings support the safety of RUL-UB ECT in combination with pharmacotherapy in the prolonging of remission in late-life depression.

Full Text

Duke Authors

Cited Authors

  • Lisanby, SH; McClintock, SM; McCall, WV; Knapp, RG; Cullum, CM; Mueller, M; Deng, Z-D; Teklehaimanot, AA; Rudorfer, MV; Bernhardt, E; Alexopoulos, G; Bailine, SH; Briggs, MC; Geduldig, ET; Greenberg, RM; Husain, MM; Kaliora, S; Latoussakis, V; Liebman, LS; Petrides, G; Prudic, J; Rosenquist, PB; Sampson, S; Tobias, KG; Weiner, RD; Young, RC; Kellner, CH; Prolonging Remission in Depressed Elderly (PRIDE) Work Group,

Published Date

  • January 2022

Published In

Volume / Issue

  • 30 / 1

Start / End Page

  • 15 - 28

PubMed ID

  • 34074611

Pubmed Central ID

  • PMC8595359

Electronic International Standard Serial Number (EISSN)

  • 1545-7214

Digital Object Identifier (DOI)

  • 10.1016/j.jagp.2021.04.006

Language

  • eng

Conference Location

  • England