Longitudinal Neurocognitive Effects of Combined Electroconvulsive Therapy (ECT) and Pharmacotherapy in Major Depressive Disorder in Older Adults: Phase 2 of the PRIDE Study
| Autor: | Sarah H. Lisanby, Rebecca G. Knapp, Lauren S. Liebman, Mustafa M. Husain, Georgios Petrides, Kristen G. Tobias, Joan Prudic, Peter B. Rosenquist, Emma T. Geduldig, Mimi C. Briggs, Matthew V. Rudorfer, William V. McCall, Styliani Kaliora, Charles H. Kellner, Samuel H. Bailine, Abeba A. Teklehaimanot, Elisabeth Bernhardt, Richard D. Weiner, Zhi-De Deng, Robert M. Greenberg, Martina Mueller, Shawn M. McClintock, George S. Alexopoulos, Vassilios Latoussakis, C. Munro Cullum, Robert C. Young, Shirlene Sampson |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pediatrics
medicine.medical_specialty medicine.medical_treatment Venlafaxine Lithium Article 03 medical and health sciences 0302 clinical medicine Electroconvulsive therapy Pharmacotherapy Medicine Humans Electroconvulsive Therapy Depression (differential diagnoses) Aged Psychomotor learning Depressive Disorder Depressive Disorder Major 030214 geriatrics business.industry Depression Venlafaxine Hydrochloride Middle Aged medicine.disease Psychiatry and Mental health Treatment Outcome Major depressive disorder Geriatrics and Gerontology Verbal memory business Neurocognitive medicine.drug |
| Zdroj: | Am J Geriatr Psychiatry |
| ISSN: | 1545-7214 |
| Popis: | Objective There is limited information regarding neurocognitive outcomes of right unilateral ultrabrief pulse width electroconvulsive therapy (RUL-UB ECT) combined with pharmacotherapy in older adults with major depressive disorder. We report longitudinal neurocognitive outcomes from Phase 2 of the Prolonging Remission in Depressed Elderly (PRIDE) study. Method After achieving remission with RUL-UB ECT and venlafaxine, older adults (≥60 years old) were randomized to receive symptom-titrated, algorithm-based longitudinal ECT (STABLE) plus pharmacotherapy (venlafaxine and lithium) or pharmacotherapy-only. A comprehensive neuropsychological battery was administered at baseline and throughout the 6-month treatment period. Statistical significance was defined as a p-value of less than 0.05 (two-sided test). Results With the exception of processing speed, there was statistically significant improvement across most neurocognitive measures from baseline to 6-month follow-up. There were no significant differences between the two treatment groups at 6 months on measures of psychomotor processing speed, autobiographical memory consistency, short-term and long-term verbal memory, phonemic fluency, inhibition, and complex visual scanning and cognitive flexibility. Conclusion To our knowledge, this is the first report of neurocognitive outcomes over a 6-month period of an acute course of RUL-UB ECT followed by one of 2 strategies to prolong remission in older adults with major depression. Neurocognitive outcome did not differ between STABLE plus pharmacotherapy versus pharmacotherapy alone over the 6-month continuation treatment phase. These findings support the safety of RUL-UB ECT in combination with pharmacotherapy in the prolonging of remission in late-life depression. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|