Effects of Continuation Electroconvulsive Therapy on Quality of Life in Elderly Depressed Patients: A Randomized Clinical Trial
Autor: | Rebecca G. Knapp, Matthew V. Rudorfer, Mustafa M. Husain, Shawn M. McClintock, Charles H. Kellner, Samuel H. Bailine, Georgios Petrides, Sarah H. Lisanby, Richard D. Weiner, Joan Prudic, W. Vaughn McCall, Peter B. Rosenquist, Robert M. Greenberg, Laryssa McCloud, Nagy A. Youssef, Mary Dooley, Martina Mueller, Robert C. Young |
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Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Poison control Venlafaxine behavioral disciplines and activities Article law.invention 03 medical and health sciences 0302 clinical medicine Electroconvulsive therapy Randomized controlled trial Quality of life law Internal medicine mental disorders Outcome Assessment Health Care medicine Secondary Prevention Humans Bipolar disorder Psychiatry Electroconvulsive Therapy Biological Psychiatry Aged Aged 80 and over Depressive Disorder Major business.industry Venlafaxine Hydrochloride Middle Aged medicine.disease Combined Modality Therapy Antidepressive Agents 030227 psychiatry Psychiatry and Mental health Schizophrenia Lithium Compounds Quality of Life Major depressive disorder Drug Therapy Combination Female business 030217 neurology & neurosurgery medicine.drug |
Popis: | We examined whether electroconvulsive therapy (ECT) plus medications ("STABLE + PHARM" group) had superior HRQOL compared with medications alone ("PHARM" group) as continuation strategy after successful acute right unilateral ECT for major depressive disorder (MDD). We hypothesized that scores from the Medical Outcomes Study Short Form-36 (SF-36) would be higher during continuation treatment in the "STABLE + PHARM" group versus the "PHARM" group. The overall study design was called "Prolonging Remission in Depressed Elderly" (PRIDE). Remitters to the acute course of ECT were re-consented to enter a 6 month RCT of "STABLE + PHARM" versus "PHARM". Measures of depressive symptoms and cognitive function were completed by blind raters; SF-36 measurements were patient self-report every 4 weeks. Participants were 120 patients60 years old. Patients with dementia, schizophrenia, bipolar disorder, or substance abuse were excluded. The "PHARM" group received venlafaxine and lithium. The "STABLE + PHARM" received the same medications, plus 4 weekly outpatient ECT sessions, with additional ECT session as needed. Participants were mostly female (61.7%) with a mean age of 70.5 ± 7.2 years. "STABLE + PHARM" patients received 4.5 ± 2.5 ECT sessions during Phase 2. "STABLE + PHARM" group had 7 point advantage (3.5-10.4, 95% CI) for Physical Component Score of SF-36 (P 0.0001), and 8.2 point advantage (4.2-12.2, 95% CI) for Mental Component Score (P 0.0001). Additional ECT resulted in overall net health benefit. Consideration should be given to administration of additional ECT to prevent relapse during the continuation phase of treatment of MDD. CLINICAL TRIALS.GOV: NCT01028508. |
Databáze: | OpenAIRE |
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