Electroconvulsive therapy (ECT) is well established as a safe and effective treatment for several psychiatric disorders. Responsiveness to ECT does not abate with age, and data indicate that the use of ECT in the treatment of psychiatric disorders in the elderly persons has increased in recent decades. Special consideration must be given to the baseline cognitive abilities of an elderly patient prior to treatment with ECT. Much of the literature on the use of ECT in the elderly persons has focused on the treatment of mood disorders, whereas less research has been devoted to its use in the treatment of other psychiatric conditions. Although depressive syndromes remain the most common indication for ECT in the elderly persons, clinicians treating elderly patients should remain aware of the safety and efficacy of this treatment modality with other psychiatric disorders. This review examines the literature on the use of ECT in elderly patients with some common neuropsychiatric disorders including catatonia, bipolar mania, schizophrenia, dementia with behavioral disturbance, and Parkinson's disease.
Thompson JW, Blaine JDUse of ECT in the United States in 1975, 1980, and 1986. Am J Psychiatry.1994;151:1657-1661.
2.
American Psychiatric Association .The Practice of ECT: Recommendations for Treatment, Training, and Privileging. Washington, DC: American Psychiatric Press; 2001.
3.
American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision . Washington, DC: American Psychiatric Association; 2000.
Takata T., Takaoka K., Fujigaki M.Catatonia in the elderly. International Journal of Psychiatry in Clinical Practice2005;9:230-237.
6.
Swartz C., Galang RLAdverse outcome with delay in identification of catatonia in elderly patients . Am J Geriatr Psychiatry. 2001;9:78-80.
7.
Morioka H., Nagatomo I., Yamada K., et al. Deep venous thrombosis of the leg due to psychiatric stupor . Psychiatry Clin Neurosci.1997;51:323-326.
8.
Carroll BTCatatonia on the consultation-liaison service. Psychosomatics . 1992;33:310-315.
9.
Bush G., Fink M., Petrides G., et al. Catatonia II: treatment with lorazepam and electroconvulsive therapy. Acta Psychiatr Scand. 1996;93:137-143.
10.
Suzuki K., Awata S., Matsuoka H.Short-term effect of ECT in middle-aged and elderly patients with intractable catatonic schizophrenia. J ECT. 2003;19:73-80.
11.
Suzuki K., Awata S., Matsuoka H.One-year outcome after response to ECT in middle-aged and elderly patients with intractable catatonic schizophrenia. J ECT. 2004;20:99-106.
12.
Suzuki K., Awata S., Takano T., et al. Continuation electroconvulsive therapy for relapse prevention in middle-aged and elderly patients with intractable catatonic schizophrenia . Psychiatry Clin Neurosci.2005;59:481-489.
13.
Madan R.Catatonia in late-life: the importance of recognizing an uncommon syndrome . Clin Geriatr. 2003;11:26-28.
14.
Little JD, Munday J., Atkins M.Right unilateral ECT at 6x seizure threshold: is it effective in the psychoses ? J ECT. 2003;19:158-163.
15.
Spear J., Ranger M., Herzberg J.The treatment of stupor associated with MRI evidence of cerebrovascular disease . Int J Geriatr Psychiatry. 1997;12:791-794.
16.
Farah A., McCall WVECT administration to a hyperthyroid patient. Convuls Ther . 1995;11:126-128.
17.
Caroff SN, Mann SC, Keck PE Jr, et al. Residual catatonic state following neuroleptic malignant syndrome . J Clin Psychopharmacol. 2000;20:257-259.
18.
Suzuki K., Awata S., Nakagawa K., et al. Catatonic stupor during the course of Parkinson's disease resolved with electroconvulsive therapy. Mov Disord.2006;21:123-124.
19.
Rohland BM, Carroll BT, Jacoby RGECT in the treatment of the catatonic syndrome. J Affect Disord . 1993;29:255-261.
20.
Van Gerpen MW, Johnson JE, Winstead DKMania in the geriatric patient population: a review of the literature. Am J Geriatr Psychiatry. 1999;7:188-202.
21.
Young RC, Gyulai L., Mulsant BH, et al. Pharmacotherapy of bipolar disorder in old age: review and recommendations . Am J Geriatr Psychiatry. 2004;12:342-257.
22.
Mukherjee S. , Sackheim HA, Schnur DBElectroconvulsive therapy of acute manic episodes: a review of 50 years'experience. Am J Psychiatry. 1994;151:169-176.
23.
Tsao CI, Jain S., Gibson RH, et al. Maintenance ECT for recurrent medication-refractory mania. J ECT. 2004;20:118-119.
24.
Husain M., Meyer D., Muttakin M., et al. Maintenance ECT for treatment of recurrent mania (letter). Am J Psychiatry.1993;150:985.
25.
McDonald WM , Thompson TRTreatment of mania in dementia with electroconvulsive therapy. Psychopharmacol Bull. 2001;35:72-82.
26.
Roth SD, Mukherjee S., Sackheim HAElectroconvulsive therapy in a patient with mania, parkinsonism, and tar-dive dyskinesia. Convuls Ther. 1988;4:92-97.
27.
Atre-Vaidya N., Jampala VCElectroconvulsive therapy in Parkinsonism with affective disorder. Br J Psychiatry. 1988;152:55-58.
28.
Weintraub D. , Lippmann SBECT for major depression and mania with advanced dementia. J ECT. 2001;17:65-67.
29.
Jeste DV, Wetherell JL, Dolder CRSchizophrenia and paranoid disorders. In: Blazer DG, Steffens DC, Busse EW, eds. Textbook of Geriatric Psychiatry. Washington, DC: American Psychiatric Publishing;2004:269-281.
30.
Palmer BW, McClure FS, Jeste DVSchizophrenia in late life: findings challenge traditional concepts . Harvard Rev Psychiatry. 2001;9:51-58.
31.
Kramer BAECT in elderly patients with schizophrenia. Am J Geriatr Psychiatry . 1999;7:171-174.
32.
Figiel GS, Botteron K., Zorumski CF, et al. The treatment of late age onset psychoses with electroconvulsive therapy. Int J Geriatr Psychiatry. 1992;7:183-189.
33.
Ota M., Mizukami K., Katano T., et al. A case of delusional disorder, somatic type, with remarkable improvement of clinical symptoms and single photon emission computed tomography findings following modified electroconvulsive therapy. Prog Neuropsychopharmacol Biol Psychiatry. 2003;27:881-884.
34.
Tariot PNTreatment of agitation in dementia. J Clin Psychiatry.1999;60(suppl 8):11-20.
35.
Livingston G., Johnston K., Katona C., et al. Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementia. Am J Psychiatry.2005;62:1996-2021.
36.
Sink KM, Holden KF, Yaffe K.Pharmacologic treatment of neuropsychiatric symptoms of dementia: a review of the evidence. JAMA. 2005;293:596-608.
37.
Carlyle W., Killick L., Ancill R.ECT: an effective treatment in the screaming demented patient. J Am Geriatr Soc. 1991;39:637.
38.
Holmberg SK, Tariot PN, Challapalli R.Efficacy of ECT for agitation in dementia. Am J Geriatr Psychiatry . 1996;4:330-334.
39.
Roccaforte WH , Wengel SP, Burke WJECT for screaming in dementia. Am J Geriatr Psychiatry. 2000;8:177.
40.
Grant JE, Mohan SNTreatment of agitation and aggression in four demented patients using ECT . J ECT. 2001;17:205-209.
41.
Price TRP , McAllister TWSafety and efficacy of ECT in depressed patients with dementia: a review of clinical experience. Convuls Ther . 1989;5:61-74.
42.
Nelson JP, Rosenberg DRECT treatment of demented elderly patients with major depression: a retrospective study of efficacy and safety. Convuls Ther . 1991;7:157-165.
43.
Koenig HG, Blazer DGMood disorders. In: Blazer DG , Steffens DC, Busse EW , eds. Textbook of Geriatric Psychiatry. Washington, DC: American Psychiatric Publishing;2004:241-268.
44.
Fochtmann L.A mechanism for the efficacy of ECT in Parkinson's disease. Convuls Ther. 1988;4:321-327.
45.
Andersen K. , Balldin J., Gottfries CG, et al. A double-blind evaluation of electroconvulsive therapy in Parkinson's disease with “on-off” phenomena. Acta Neurol Scand.1987;76:191-199.
46.
Kennedy R., Mittal D., O'Jile J. Electroconvulsive therapy in movement disorders: an update . J Neuropsychiatry Clin Neurosci.2003;15:407-421.
47.
Kellner CH, Beale MD, Pritchett JT, et al. Electroconvulsive therapy and Parkinson's disease: the case for further study. Psychopharmacol Bull. 1994 ;30:495-500.
48.
Ismail K., Howard R., Lovestone S.Acceptability of electroconvulsive therapy to patients with Parkinson's disease . J Neurol Neurosurg Psychiatry. 1994 ;57:383-384.
49.
Pridmore S. , Pollard C.Electroconvulsive therapy in Parkinson's disease: 30 month follow up. J Neurol Neurosurg Psychiatry . 1996;60:693.
50.
Rasmussen K. , Abrams R.Treatment of Parkinson's disease with electroconvulsive therapy. Psychiatr Clin North Am. 1991;14:925-933.
