Guidelines For Dx and Tx of Depression in Older Adults: Japanese Society of Mood Disorders Include ECT

Out on PubMed, from authors in Japan, is this paper:




The abstract is copied below:




The paper is here.


And from the text, the sections on ECT:





In these guidelines, ECT is given reasonable consideration. I do, however, dislike the above yellow-highlighted sentence in which ECT and TMS are mentioned together indiscriminately.
Treatment guidelines in general are very important for maintaining the recognition of ECT as a standard treatment; whenever a guideline recognizes ECT appropriately, we move away from the inappropriate categorization of ECT as a "last resort."
This document is a fairly good primer on geriatric depression; the fact that the the non-ECT parts (the majority) are so boring, makes me realize how privileged we are to be able to offer such a dramatically effective treatment to the segment of the depressed patient population who needs relief most.
A full read is only recommended for those who wish to brush up on pharmacotherapy/psychotherapy in geriatric depression, ~ 15 minutes.










Comments

Post a Comment

Popular posts from this blog

ECT plus Antidepressants: a Review

Out on PubMed, from researchers in Rotterdam, The Netherlands, is this review: Influence of an adjuvant antidepressant on the efficacy of  electroconvulsive  therapy: A systematic review and meta-analysis. Pluijms EM, Kamperman AM, Hoogendijk WJ, Birkenhäger TK, van den Broek WW. Aust N Z J Psychiatry. 2020 Sep 8:4867420952543. doi: 10.1177/0004867420952543. Online ahead of print. PMID:  32900217 Here is the "Conclusion" section from the text: Our results suggest that an adjuvant antidepressant enhances the efficacy of ECT in patients with major depression. Although the included studies had some methodological limitations, effect sizes were consistently small to moderate. We speculate that modern-day controlled trials using adequately dosed TCAs and MAOIs will most likely result in larger effect sizes. From a clinical point of view, we prefer an adjuvant TCA to an adjuvant MAOI, since TCAs are generally safe to use with ECT ( American Psychiatric Association, 2001 ; ...
Read more

Clinical Phenotype of Behavioral-Variant Frontotemporal Dementia Reversed by ECT: A Case Report

Image
Out on PubMed, from authors in Germany, is this case report and literature review: Clinical Phenotype of Behavioral-Variant Frontotemporal Dementia Reversed by  ECT : A Case Report. Breitling B, Bartels C, Lange C, Bouter C, Falk HS, Wiltfang J, Zilles-Wegner D, Besse M. Neuropsychobiology. 2024 Dec 2:1-12. doi: 10.1159/000541668. Online ahead of print. PMID:  39622206 The abstract is copied below: Introduction: Diagnosis of frontotemporal dementia (FTD) remains difficult even in the presence of core clinical and imaging features. Furthermore, disease-modifying treatments are lacking. Case presentation: Here, we report a case of a patient with clinical and imaging features of FTD. Electroconvulsive therapy (ECT) was used to target affective and catatonic symptoms. After ECT, the patient showed improvements not only in affective symptoms but also in cognitive domains, leading to a marked improvement in the patient's level of functioning. Conclusion: Against the background of di...
Read more

Early Use of the Name "ECT"- Sacklers in 1949

Image
 "Classics in ECT" brings you this study from Creedmore State Hospital in 1949: Nonconvulsive biochemotherapy with histamine and electric convulsive therapy; a comparative study on hospitalized psychotics with a control  ECT  series. SACKLER AM, SACKLER MD, SACKLER RR. J Nerv Ment Dis. 1949 Sep;110(3):185-97. doi: 10.1097/00005053-194911030-00001. PMID:  18138865 The pdf is here . I originally choose this article as the earliest in PubMed to use the name, "ECT," although it also uses "electric [sic] convulsive therapy."  The very first PubMed "ECT" citation is from 1947, but it is written "E.C.T." and also reports a complication, so we prefer this one. Nomenclature aside, this turns out to be an interesting read, with what would now be considered a somewhat bizarre study comparing histamine therapy with ECT. Among the interesting details are the inclusion of a couple of patients with postpartum psychosis and the observation that longer ...
Read more