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Electroconvulsive Therapy in Old-Old Patients

Received April 6, 1999; revised June 1, 1999; accepted August 12, 1999. From the Department of Psychiatric Medicine, East Carolina University School of Medicine, Greenville, North Carolina. Address correspondence to Dr. Manly, Park Ridge Hospital, P.O. Box 1569, Fletcher, NC 28732.

The authors compared falls, cardiovascular factors, confusion, gastrointestinal, pulmonary, and metabolic side effects for "old-old" (>75 years) patient groups treated with either electroconvulsive therapy (ECT) or pharmacotherapy. A subset of a pharmacotherapy patient group was selected to match for age, sex, and diagnosis in a case-control design. Side effects were recorded from each selected patient's medical record and compared between groups. Patients receiving ECT showed fewer cardiovascular and gastrointestinal side effects. Patients receiving ECT had longer lengths of stay and more favorable outcomes. Overall, there was a tendency for ECT to result in fewer side effects and better treatment outcomes. ECT appears to be relatively safe and more effective than pharmacotherapy for major depressive disorders in old-old patients.

Key Words: Depression • ECT • Oldest-Old