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
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