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

Publication ,  Journal Article
Lisanby, SH; McClintock, SM; McCall, WV; Knapp, RG; Cullum, CM; Mueller, M; Deng, Z-D; Teklehaimanot, AA; Rudorfer, MV; Bernhardt, E; Prudic, J ...
Published in: Am J Geriatr Psychiatry
January 2022

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.

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Published In

Am J Geriatr Psychiatry

DOI

EISSN

1545-7214

Publication Date

January 2022

Volume

30

Issue

1

Start / End Page

15 / 28

Location

England

Related Subject Headings

  • Venlafaxine Hydrochloride
  • Treatment Outcome
  • Middle Aged
  • Lithium
  • Humans
  • Geriatrics
  • Electroconvulsive Therapy
  • Depressive Disorder, Major
  • Aged
  • 5203 Clinical and health psychology
 

Citation

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Lisanby, S. H., McClintock, S. M., McCall, W. V., Knapp, R. G., Cullum, C. M., Mueller, M., … Prolonging Remission in Depressed Elderly (PRIDE) Work Group. (2022). Longitudinal Neurocognitive Effects of Combined Electroconvulsive Therapy (ECT) and Pharmacotherapy in Major Depressive Disorder in Older Adults: Phase 2 of the PRIDE Study. Am J Geriatr Psychiatry, 30(1), 15–28. https://doi.org/10.1016/j.jagp.2021.04.006
Lisanby, Sarah H., Shawn M. McClintock, William V. McCall, Rebecca G. Knapp, C Munro Cullum, Martina Mueller, Zhi-De Deng, et al. “Longitudinal Neurocognitive Effects of Combined Electroconvulsive Therapy (ECT) and Pharmacotherapy in Major Depressive Disorder in Older Adults: Phase 2 of the PRIDE Study.Am J Geriatr Psychiatry 30, no. 1 (January 2022): 15–28. https://doi.org/10.1016/j.jagp.2021.04.006.
Lisanby SH, McClintock SM, McCall WV, Knapp RG, Cullum CM, Mueller M, et al. Longitudinal Neurocognitive Effects of Combined Electroconvulsive Therapy (ECT) and Pharmacotherapy in Major Depressive Disorder in Older Adults: Phase 2 of the PRIDE Study. Am J Geriatr Psychiatry. 2022 Jan;30(1):15–28.
Lisanby, Sarah H., et al. “Longitudinal Neurocognitive Effects of Combined Electroconvulsive Therapy (ECT) and Pharmacotherapy in Major Depressive Disorder in Older Adults: Phase 2 of the PRIDE Study.Am J Geriatr Psychiatry, vol. 30, no. 1, Jan. 2022, pp. 15–28. Pubmed, doi:10.1016/j.jagp.2021.04.006.
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. Longitudinal Neurocognitive Effects of Combined Electroconvulsive Therapy (ECT) and Pharmacotherapy in Major Depressive Disorder in Older Adults: Phase 2 of the PRIDE Study. Am J Geriatr Psychiatry. 2022 Jan;30(1):15–28.
Journal cover image

Published In

Am J Geriatr Psychiatry

DOI

EISSN

1545-7214

Publication Date

January 2022

Volume

30

Issue

1

Start / End Page

15 / 28

Location

England

Related Subject Headings

  • Venlafaxine Hydrochloride
  • Treatment Outcome
  • Middle Aged
  • Lithium
  • Humans
  • Geriatrics
  • Electroconvulsive Therapy
  • Depressive Disorder, Major
  • Aged
  • 5203 Clinical and health psychology